scholarly journals Quality of referrals to old age psychiatry following introduction of the single assessment process

2006 ◽  
Vol 30 (12) ◽  
pp. 452-453 ◽  
Author(s):  
Kathleen Ferriter ◽  
Partha Gangopadhyay ◽  
Ramin Nilforooshan ◽  
Mark Ardern ◽  
James Warner
Keyword(s):  
Patient Care ◽  
Old Age ◽  
Clinical Utility ◽  
Assessment Process ◽  
Clinical Implications ◽  
Quality Of Information ◽  
Clinical Communication ◽  
Before And After ◽  
Old Age Psychiatry

Aims and MethodWe sought to identify changes in the quality of information in referrals to an old age psychiatry service before and after the introduction of the single assessment process. Referrals were compared in terms of length, legibility, information and clinical utility.ResultsCompared with letters before the introduction of the single assessment process, referrals made on the new forms took longer to read (mean 96 v. 124 s, P=0.001), had more illegible sections (P=0.011), contained less information (P=0.026) and were judged to be less clinically useful (P=0.001).Clinical ImplicationsThe introduction of the single assessment process has impaired clinical communication between general practitioners and psychiatrists, and might be prejudicial to patient care.

Feasibility and Clinical Implications of Remotely Guided Ultrasound Examinations

2020 ◽  
Vol 91 (7) ◽  
pp. 592-596
Author(s):  
Quinn Dufurrena ◽  
Kazi Imran Ullah ◽  
Erin Taub ◽  
Connor Leszczuk ◽  
Sahar Ahmad
Keyword(s):  
Clinical Utility ◽  
Regional Wall Motion ◽  
Subjective Assessment ◽  
Clinical Implications ◽  
Pilot Studies ◽  
Objective Quality ◽  
The Us ◽  
Regional Wall Motion Abnormalities ◽  
Wall Motion Abnormalities

BACKGROUND: Remotely guided ultrasound (US) examinations carried out by nonmedical personnel (novices) have been shown to produce clinically useful examinations, at least in small pilot studies. Comparison of the quality of such exams to those carried out by trained medical professionals is lacking in the literature. This study compared the objective quality and clinical utility of cardiac and pulmonary US examinations carried out by novices and trained physicians.METHODS: Cardiac and pulmonary US examinations were carried out by novices under remote guidance by an US expert and independently by US trained physicians. Exams were blindly evaluated by US experts for both a task-based objective score as well as a subjective assessment of clinical utility.RESULTS: Participating in the study were 16 novices and 9 physicians. Novices took longer to complete the US exams (median 641.5 s vs. 256 s). For the objective component, novices scored higher in exams evaluating for pneumothorax (100% vs. 87.5%). For the subjective component, novices more often obtained clinically useful exams in the assessment of cardiac regional wall motion abnormalities (56.3% vs. 11.1%). No other comparisons yielded statistically significant differences between the two groups. Both groups had generally higher scores for pulmonary examinations compared to cardiac. There was variability in the quality of exams carried out by novices depending on their expert guide.CONCLUSION: Remotely guided novices are able to carry out cardiac and pulmonary US examinations with similar, if not better, technical proficiency and clinical utility as US trained physicians, though they take longer to do so.Dufurrena Q, Ullah KI, Taub E, Leszczuk C, Ahmad S. Feasibility and clinical implications of remotely guided ultrasound examinations. Aerosp Med Hum Perform. 2020; 91(7):592–596.

scholarly journals Should old age psychiatry develop memory clinics? A comparison with domiciliary work

2004 ◽  
Vol 28 (3) ◽  
pp. 78-82 ◽  
Author(s):  
S. Simpson ◽  
D. Beavis ◽  
J. Dyer ◽  
S. Ball
Keyword(s):  
Old Age ◽  
Clinical Implications ◽  
Memory Clinic ◽  
Retrospective Case ◽  
Memory Clinics ◽  
Old Age Psychiatry ◽  
Psychiatric Complications ◽  
To Receive ◽  
Case Note Review

Aims and MethodMemory clinics have become very popular in old age psychiatry and there is some pressure for them to be developed in old age services. However, there is little evidence to suggest that they are more advantageous over the traditional domiciliary visits or who should be seen in clinic. This was a naturalistic comparison of 76 consecutive new referrals to a memory clinic, with 74 consecutive new domiciliary requests within the same service over the same period of time. A retrospective case note review collected the clinical features and an 18-month prospective follow-up examined the subsequent clinical management.Clinical ImplicationsThe two groups were characterised more by their similarities than their differences. However, the domiciliary group had greater behavioural and psychological complications. The memory clinic patients were less likely to receive psychotropic medication and here more likely to be followed up.ResultsWe conclude that memory clinics might be less suitable for patients with prominent psychiatric complications. Memory clinics could complement the domiciliary model by providing early psychosocial/neuropsychiatric approaches, although this is likely to lead to an increased clinical case-load.

An audit of emergency contraception: a look at patient characteristics and the effects of a consultation proforma

1998 ◽  
Vol 9 (1) ◽  
pp. 48-50 ◽  
Author(s):  
H Nanthakumaran ◽  
A K Sullivan ◽  
F C Boag
Keyword(s):  
Sexual Health ◽  
Transmitted Disease ◽  
Patient Characteristics ◽  
Quality Of Information ◽  
Sexually Transmitted ◽  
Clinical Notes ◽  
Postcoital Contraception ◽  
Before And After ◽  
Health Screen

Summary: The aim of this study was to examine the characteristics of patients requesting emergency postcoital contraception at a genitourinary medicine (GUM) clinic. We also compared the quality of information obtained during the consultation, before and after a proforma was introduced. A retrospective review of all clinical notes of patients who attended for postcoital contraception between January and December 1994 and April to June 1995 was performed. Eighty-three per cent of patients were aged 17-29 years, 68.8% were in relationship, 41.3% were not using regular contraception, 33.8% accepted a sexual health screen and of these, 14.8% had a concurrent sexually transmitted disease (STD). The introduction of a consultation proforma significantly improved certain areas of the consultation. The results suggest that sexual health screens should be encouraged in women attending GUM clinics for postcoital contraception and that the use of a proforma improves the quality of information obtained.

scholarly journals Patients' views on the quality of care when receiving electroconvulsive therapy

2007 ◽  
Vol 31 (11) ◽  
pp. 414-417 ◽  
Author(s):  
Kerry Kershaw ◽  
Lauren Rayner ◽  
Robert Chaplin
Keyword(s):  
Quality Of Care ◽  
Patient Care ◽  
Electroconvulsive Therapy ◽  
Clinical Implications ◽  
Patient Views ◽  
Quality Of Patient Care

AIMS AND METHODTo examine patients' views on the quality of care they received before, during and after electroconvulsive therapy (ECT), a questionnaire was completed by 389 patients who had received ECT at ECT Accreditation Service (ECTAS) member clinics.RESULTSThe nine key standards set by ECTAS relating to quality of patient care were rated as having been met by 65% or more respondents. Most patients found staff friendly and reassuring and often commented on how this had helped reduce their anxiety prior to ECT. Patients were less positive about standards relating to being introduced to staff prior to ECT, and the quality of the waiting and post-recovery areas.CLINICAL IMPLICATIONSPatient views are important indicators of quality of care and should be used to improve ECT practice. Anxiety about ECT is helped by supportive and caring staff. Improvements could be made to practices related to waiting for and recovering from ECT.

scholarly journals Pengembangan Sistem Pendukung Keputusan Untuk Mendukung Penegakkan Diagnosa TB Dots Di Rumah Sakit Aisyiyah Muntilan

2016 ◽  
Vol 4 (2) ◽  
pp. 123-128
Author(s):  
Susanti Susanti ◽  
Mateus Sakundarno Adi ◽  
Atik Mawarni
Keyword(s):  
Information System ◽  
Decision Support ◽  
Decision Support System ◽  
Support System ◽  
T Test ◽  
P Value ◽  
Research Subjects ◽  
Quality Of Information ◽  
Before And After

Tuberculosis (TB) disease intervention is a national program and being a target of MDGs. Therefore, a government determined minimum service standards of a hospital that had to be implemented in all health service units and hospitals in Indonesia. A strategy of DOTS at Aisyiyah Hospital in Muntilan had been available particularly in terms of case finding. Notwithstanding, a process of patient diagnosis had not been implemented in accordance with a standard of human resource. Number of medical officers at a TB DOTS unit was not sufficient. In addition, quality of information like completeness, accurateness in diagnosis, and timeliness in reporting TB cases had not achieved a target. The aim of this study was to develop decision support system of TB as an effort to systematically diagnose and manage data of TB based on the standard. This was qualitative-quantitative research. A qualitative method was used to identify each step of information system development. Meanwhile, a quantitative method was used to assess quality of information between before and after developing information system using pre-experimental design (the one group pre and posttest design). Qualitative data were collected by conducting indepth interview, whereas quantitative data were collected using checklist. Data were analysed using T test. Research object was decision support system before and after applying at TB unit at Aisyiyah Hospital in Muntilan. Research subjects consisted of four TB officers as main informants. Informants for triangulation purpose consisted of head of SIMRS and head of medical services. The results of T test showed that variables of completeness, accurateness, and preciseness after developing the decision support system were better than that of before developing the system (p-value = 0.000). As suggestions, head of SIMRS needs to conduct further development of decision support system of TB in another unit particularly in inpatient unit. The decision support system needs to be evaluated and adjusted with the standard.

scholarly journals Psychotherapy and old age psychiatry

1999 ◽  
Vol 23 (3) ◽  
pp. 149-153 ◽  
Author(s):  
Jane Garner
Keyword(s):  
Older People ◽  
Old Age ◽  
Older Patients ◽  
Psychological Intervention ◽  
Clinical Implications ◽  
Emotional Life ◽  
The Future ◽  
Old Age Psychiatry

Aims and MethodsThis report was prepared as the basis for wider consultation within the Old Age Faculty and the College. Some literature and practice is reviewed and practical suggestions made for the future in this area.ResultsAlthough older patients are less likely to be refused for psychological intervention attitudes are slowly changing.Clinical implicationsThe clinical implications of this development include a greater consideration of the unique emotional life of each of our patients and an improved understanding of our reluctance to engage in psychotherapeutic work with older people.

scholarly journals Role and responsibility of the speciality tutor

1999 ◽  
Vol 23 (3) ◽  
pp. 170-172
Author(s):  
Jane Garner ◽  
Yong Lock Ong
Keyword(s):  
Old Age ◽  
Clinical Implications ◽  
Job Description ◽  
Old Age Psychiatry ◽  
Training Programmes

Aims and methodIn order to identify the role and responsibility of the speciality tutor, the tutors' post in old age psychiatry was compared across two regions.ResultsThe role was narrow; but different in the two regions depending on training programmes.Clinical implicationsTutors in all faculties should have an expanded and standardised job description, separate from the role of the regional representative, in order to strengthen the input of the specialisms to training at all levels.

scholarly journals Audit: prescription of ‘as required’ (p.r.n.) medication in an in-patient setting

1999 ◽  
Vol 23 (7) ◽  
pp. 413-416 ◽  
Author(s):  
M. F. Bowden
Keyword(s):  
Standard Setting ◽  
Clinical Implications ◽  
Before And After ◽  
High Doses

Aims and methodThis audit examines the quality of ‘as required’ (p.r.n.) prescribing for in-patients before and after standard setting.ResultsThere were improvements in writing oral/intramuscular prescriptions and in the use of different drugs regularly and p.r.n. There was a trend for improvement in completion of guidelines for those on high doses but completion was not influenced by hidden p.r.n. prescribing. Writing p.r.n. prescriptions as a ranged dose was common and did not improve significantly.Clinical implicationsBy using some simple measures, improvements in some aspects of potentially problematic p.r.n. medication can be achieved.

Principles of service provision in old age psychiatry

2013 ◽  
Author(s):  
Tom Dening
Keyword(s):  
Older People ◽  
Social Services ◽  
Old Age ◽  
Memory Assessment ◽  
Policy Context ◽  
Effective Care ◽  
Challenges And Opportunities ◽  
Old Age Psychiatry ◽  
Fair Access

This chapter outlines the history, underlying principles and policy context for contemporary mental health services for older people. The usual components of such services, including community health teams, memory assessment services, day facilities, consultation-liaison services in general hospitals, and in-patient psychiatric care for older people are all discussed. Alongside these more familiar elements however, there have been other recent, sometimes destabilising, changes, including moves towards age-inclusive services and changes in working patterns for psychiatrists and other professionals. Working closely with primary care, greater integration with social services and providing support to care homes are all part of the current agenda. It is important to measure the quality of services and to ensure the populations who may be disadvantaged receive fair access to effective care and treatment. Obviously, the future increase in the numbers of very old people brings both challenges and opportunities for old age psychiatry services.

Sex in old age

2012 ◽  
pp. 1567-1570
Author(s):  
John Kellett ◽  
Catherine Oppenheimer
Keyword(s):  
Quality Of Life ◽  
Old Age ◽  
Sexual Behaviour ◽  
Old Age Psychiatry ◽  
Sexual Concerns

Ageing brings increasing diversity. This certainly applies to sexual behaviour. Those who work in the field of old age psychiatry can help their patients by understanding this diversity, making it safe and acceptable for patients to talk about whatever sexual concerns they have, and helping them in the acquisition of all the information they need. Sex in old age is not the frightening imperative of the teenager, but it can still contribute greatly to the quality of life.

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