Telemedicine services to a county jail

Local and county jails rarely offer telepsychiatry services to their inmates. We have established a telepsychiatry pilot project between the Kansas University Medical Center and the Lyon County Jail in Emporia, Kansas. A total of 264 telepsychiatry consultations were conducted with jail inmates. Of these, 70 were initial evaluations and 194 were follow-up visits; only one inmate refused to be seen. Approximately one-third of all inmates were seen for psychiatric consultation within one week of their incarceration and 68% were seen within one month of incarceration. Among lessons learned during the first year of service were: the monthly demand for consultations was five times greater than projected; moderately to severely ill inmates with a broad range of psychiatric illness can be seen and treated effectively using videoconferencing; and the technology was accepted by the jail personnel and the inmates alike and integrated into the jail's routine in terms of the delivery of psychiatric care.

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Engaging Housestaff as Informatics Collaborators: Educational and Operational Opportunities

Applied Clinical Informatics ◽

10.1055/s-0041-1740258 ◽

2021 ◽

Vol 12 (05) ◽

pp. 1150-1156

Author(s):

Jared A. Shenson ◽

Ivana Jankovic ◽

Hyo Jung Hong ◽

Benjamin Weia ◽

Lee White ◽

...

Keyword(s):

Positive Impact ◽

Care Delivery ◽

Medical Center ◽

Academic Medical Center ◽

Clinical Information ◽

Lessons Learned ◽

First Year ◽

Hospital Governance ◽

Staff Members ◽

It Systems

Abstract Background In academic hospitals, housestaff (interns, residents, and fellows) are a core user group of clinical information technology (IT) systems, yet are often relegated to being recipients of change, rather than active partners in system improvement. These information systems are an integral part of health care delivery and formal efforts to involve and educate housestaff are nascent. Objective This article develops a sustainable forum for effective engagement of housestaff in hospital informatics initiatives and creates opportunities for professional development. Methods A housestaff-led IT council was created within an academic medical center and integrated with informatics and graduate medical education leadership. The Council was designed to provide a venue for hands-on clinical informatics educational experiences to housestaff across all specialties. Results In the first year, five housestaff co-chairs and 50 members were recruited. More than 15 projects were completed with substantial improvements made to clinical systems impacting more than 1,300 housestaff and with touchpoints to nearly 3,000 staff members. Council leadership was integrally involved in hospital governance committees and became the go-to source for housestaff input on informatics efforts. Positive experiences informed members' career development toward informatics roles. Key lessons learned in building for success are discussed. Conclusion The council model has effectively engaged housestaff as learners, local champions, and key informatics collaborators, with positive impact for the participating members and the institution. Requiring few resources for implementation, the model should be replicable at other institutions.

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Changing Characteristics of Psychiatric Consultation in a University Hospital

Canadian Psychiatric Association Journal ◽

10.1177/070674376901400306 ◽

1969 ◽

Vol 14 (3) ◽

pp. 259-266 ◽

Cited By ~ 5

Author(s):

Peter C. Whybrow ◽

Roger F. Spencer

Keyword(s):

Psychiatric Care ◽

University Hospital ◽

Medical Patients ◽

Psychiatric Consultation ◽

Psychiatric Disturbance ◽

Factors Influencing ◽

The Future ◽

One Year ◽

Accuracy Of Prediction

Fifty-seven patients were referred for psychiatric consultation during a two-month period. One year later adequate follow-up data were obtained on 46 persons. The study evaluated the outcome of the original psychiatric disturbance in these patients, the accuracy of prediction by the psychiatric consultants and the factors influencing outcome. The recommendations most frequently followed are noted and the implications of the study for the future psychiatric care of general medical patients are discussed.

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Outcome of Closed Reduction of Developmental Dysplasia of Hip Before First Year of Age, A Retrospective Cohort Study, Saudi Arabia

10.21203/rs.3.rs-109277/v1 ◽

2020 ◽

Author(s):

Fahad AlShayhan ◽

Abdulmonem Alsiddiky ◽

Raghad Barri

Keyword(s):

Closed Reduction ◽

Open Reduction ◽

Medical Center ◽

Developmental Dysplasia ◽

First Year ◽

Developmental Dysplasia Of Hip ◽

Class 1 ◽

One Year ◽

Skin Traction

Abstract Background: Developmental dysplasia of hip (DDH) management is challenging hence there is no fixed rules or radiographic criteria to assess and manage DDH. There are many treating modalities including closed reduction, open reduction, skin traction, hip Spica and many others. This study is to assess the outcome of closed reduction in patients below 12 months of ages.Method: A retrospective study among patients with DDH who underwent closed reduction before the first year of age in a major referral medical center. The study included 100 patients and 168 hips. Average of follow up period was 5.97 years (±3.01). Couple of variables were measured in AP x ray of pelvis to assess the outcome of closed reduction. Results: Most of the hips were grade 1 and 2 according to the IHDI (International hip dysplasia institution) classification. Significant improvement in the acetabular index post closed reduction. In addition to the normalizing of CE angel's values. Also, majority of hips were severin's class 1 and 2 which were associated with good outcome.Conclusion: Safe closed reduction in patients with DDH below one year of age had a great outcome, less AVN, less growth complications and decrease the need of future open reduction.

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Abstract T P184: Outpatient Evaluation of Transient Ischemic Attack (TIA) Patients

Stroke ◽

10.1161/str.45.suppl_1.tp184 ◽

2014 ◽

Vol 45 (suppl_1) ◽

Author(s):

Nagakrishnal Nachimuthu ◽

Michael E Chan ◽

Martin I Amor ◽

Alex Puma ◽

Florence Armour ◽

...

Keyword(s):

Medical Center ◽

Cost Savings ◽

Retrospective Chart Review ◽

Final Diagnosis ◽

Primary Diagnosis ◽

Diagnostic Evaluation ◽

First Year ◽

Cerebrovascular Event ◽

Lipid Panel

Objectives: We have started an open-access outpatient TIA Rapid Evaluation Center (TREC) at our community medical center. Patients referred to the TREC are seen on the next weekday and undergo a diagnostic evaluation then consultation with a stroke neurologist. The decision to refer a TIA patient to the TREC is left to the discretion of the attending physician. METHODS: We have collected prospective data from all TREC patients, including follow-up contact at 3 and 12 months to check for future cerebrovascular events. We performed a retrospective chart review on all patients admitted to the hospital with a primary diagnosis of TIA during the same period. This study had IRB approval. RESULTS: We saw 74 TREC patients within an average of 1.25 days of referral during its first year of operation, 56 from the emergency room and 18 from physician offices. Only 2 TREC patients needed admission to the hospital, the remainder completed their evaluation as out-patients. Only 1 TREC patient had a follow-up cerebrovascular event. During this same time period, 88 patients were admitted to the hospital with a primary diagnosis of TIA. Patients referred to the TREC had lower ABCD2 scores (average of 1.8 vs. 3.8, p <0.001) and were less likely to have a final diagnosis of TIA (19% vs. 77% p<0.001) than the hospitalized patients. More hospitalized TIA patients were seen on weekdays than weekends (74% vs. 27%). Nearly all patients underwent CT scan, lipid panel and EKG. However, TREC patients were more likely to undergo carotid ultrasound (99% vs. 84%, p=0.001) and MRI of the brain (89% vs. 68%, p=0.001). Hospital reimbursement from Medicare is $904 for a TREC patient and $5500 for a TIA hospitalization. CONCLUSIONS: 40% of all TIA patients at our hospital were referred to the TREC and seen within 1.25 days during its first year of operation. TIA patients referred to the TREC had lower ABCD2 scores and were less likely to have a final diagnosis of TIA. Day of the week seen did not influence the referral decision. TREC patients were more likely to have a complete diagnostic evaluation at a cost savings of $4600 for Medicare patients. Out-patient evaluation of TIA can be an efficient, safe, and less costly alternative to hospital admission.

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Implementation of a Direct Oral Anticoagulation Screening Service at a Large Academic Medical Center Provided by a Pharmacist-managed Antithrombosis Clinic as a Method to Expand Antithrombotic Stewardship Efforts

Journal of Pharmacy Practice ◽

10.1177/0897190018799200 ◽

2018 ◽

Vol 33 (3) ◽

pp. 271-275 ◽

Cited By ~ 3

Author(s):

Ellen M. Uppuluri ◽

Meghan N. McComb ◽

Nancy L. Shapiro

Keyword(s):

Medical Center ◽

Oral Anticoagulants ◽

Direct Oral Anticoagulants ◽

Academic Medical Center ◽

Electronic Prescribing ◽

First Year ◽

Screening Service ◽

Medication Access ◽

Academic Medical

Background: How and when to monitor direct oral anticoagulants (DOACs) for safety and efficacy is a question many anticoagulation clinics are trying to answer. A pharmacist-led antithrombosis clinic (ATC) initiated a clinical service to provide oversight for all prescribed DOACs. Objective: Describe the implementation and outcomes of a DOAC screening service. Methods: The service was initiated utilizing a daily electronic prescribing report of DOAC prescriptions. Prescriptions were reviewed by clinical pharmacists to assess patient insurance, eligibility, and accuracy of prescribed doses. Results: In the first year since service implementation in April 2016, 317 new prescriptions and 595 refill prescriptions were reviewed. A DOAC service pharmacist was able to reach 125 (39.4%) of 317 patients about their new prescription and 59 (9.9%) of 595 refill patients to provide education and follow-up on management as needed. Interventions were performed for 79 (28%) of 317 new prescriptions and 86 (14.5%) of 595 refill prescriptions. Common interventions with new prescriptions include contacting the prescriber for a medication or dose change (25.4%), assistance with medication access (21.5%), and coordinating appropriate lab and provider follow up (21.5%). Common interventions with refill prescriptions include recommending appropriate follow-up (50%) and contacting the prescriber for medication or dosage change (24.4%). Conclusion: Implementation of a DOAC screening service identified and resolved dosing errors, improved medication access, provided patient education, and improved follow-up.

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Supervision: Supervision and Clinical Practicum in Telepractice

Perspectives on Administration and Supervision ◽

10.1044/aas21.1.30 ◽

2011 ◽

Vol 21 (1) ◽

pp. 30-34 ◽

Cited By ~ 3

Author(s):

Sena Crutchley

Keyword(s):

North Carolina ◽

Pilot Project ◽

First Year ◽

University Of North Carolina ◽

Speech Language Pathology ◽

Support Personnel ◽

Clinical Practicum ◽

Training Support ◽

Language Pathology ◽

The University

This article describes how a telepractice pilot project was used as a vehicle to train first-year graduate clinicians in speech-language pathology. To date, six graduate clinicians have been trained in the delivery of telepractice at The University of North Carolina at Greensboro. Components of telepractice training are described and the benefits and limitations of telepractice as part of clinical practicum are discussed. In addition, aspects of training support personnel involved in telepractice are outlined.

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