Applying changes made during the COVID-19 pandemic to the future: trauma and orthopaedics

2021 ◽  
Vol 27 (4) ◽  
pp. 1-7
Author(s):  
Hafiz Muhammad Umer ◽  
Hafiz Javaid Iqbal ◽  
Mark Webb ◽  
William James Harrison
Keyword(s):  
Public Health ◽  
Health Service ◽  
National Level ◽  
Waiting Lists ◽  
Operating Theatre ◽  
Specialty Training ◽  
Lessons Learnt ◽  
The Future ◽  
Collaborative Working ◽  
British Orthopaedic Association

The NHS has made significant changes to practice and specialty training in trauma and orthopaedics as a result of the COVID-19 pandemic. This article looks at the positive and innovative changes along with lessons learnt, which could affect policies in a new challenging post-pandemic health service. At a national level, Public Health England, the British Orthopaedic Association and the Royal Colleges have issued a number of guidelines, which have evolved throughout the pandemic. Developing resilient rotas, virtual clinics, teleconsultations, webinar-based training and operating theatre reorganisation are just some examples of how collaborative working has led to positive changes, despite the huge challenges and hardships created by COVID-19. As we emerge from this crisis, the field of trauma and orthopaedics will need to prepare for the challenges of patient backlogs, neglected trauma and long waiting lists. A continuation of the innovative and collaborative working seen during the pandemic will be crucial to cope with the post-COVID-19 world of orthopaedics.

Human Resources for Health in India: Strategic Options for Transforming Health Systems Towards Improving Health Service Delivery and Public Health

2021 ◽  
pp. 097206342199500
Author(s):  
Sanjay Zodpey ◽  
Himanshu Negandhi ◽  
Ritika Tiwari
Keyword(s):  
Public Health ◽  
Health Service ◽  
Service Delivery ◽  
Human Resources ◽  
Health System ◽  
Human Resources For Health ◽  
National Level ◽  
Health Service Delivery ◽  
Lessons Learnt ◽  
Strategic Options

Introduction: The health workforce is the channel for delivering health interventions to populations. A critical mass of health professionals is necessary to manage a health system and is often a crucial limiting factor in the delivery of quality health services. India’s current situation, juxtaposed with its medium-term and long-term HRH (human resources for health) requirements, necessitates reassessing the policy levers that are available at the national level. Objective: To suggest strategic options to recommend India’s way forward to meet challenges related to health service delivery and public health with an HRH focus. Methodology: We reviewed and compared studies from different countries which focused on strengthening HRH at the national level. A two-step approach towards identifying and selecting HRH strategic options was adopted: desk review and discussions. A list of strategic options for reforming the current state of HRH in India was developed on the basis of lessons learnt from the review. These options were then scored and plotted on a grid (for innovation, disruption, difficulty of implementation, budget for implementation, importance and time period for implementation) in discussion with experts. Result: Based on the lessons learnt, eight strategic options were suggested for India: instituting a national HRH body; developing partnership models for the public sector and the private sector; setting benchmark HRH ratios; allocating at least 2.5% of the GDP to health; allocating at least 25% of all development assistance for health to HRH; halving the current levels of disparity in health worker distribution between urban and rural areas; evaluating HRH support through the National Health Mission (NHM); and maintaining a live register of HRH. Conclusion: The research is timely as India moves towards the implementation of the Sustainable Development Goals (SDGs) with a particular focus on universal health coverage (UHC) and Ayushman Bharat Yojana. The suggested strategic options for the way forward shall help India in dealing with the current health crisis to emerge with a strong public health system.

Neuroradiological Assessment of Referrals for MR Brain Scan: Our Experience

2005 ◽  
Vol 18 (1) ◽  
pp. 9-15
Author(s):  
M. Leonardi ◽  
M. Maffei ◽  
S. Battaglia ◽  
C. Barbara ◽  
P. Cenni ◽  
...  
Keyword(s):  
Public Health ◽  
Health Service ◽  
Public Health Service ◽  
Waiting Lists ◽  
Ct Scans ◽  
Radiological Assessment ◽  
Appropriateness Criteria ◽  
Experimental Project ◽  
The Impact ◽  
Mr Scanning

The growing demand for brain MR scans in recent years has led to long waiting lists and indiscriminate referral with respect to the clinical need for imaging and appropriateness criteria for MR scanning. To overcome this problem, the Bologna Public Health Service in conjunction with S. Orsola-Malpighi Hospital devised an experimental project instituting a radiological assessment prior to booking MR scans, implemented on 1st November 2003. The assessment is carried out by doctors in the Radiology and neuroradiology units to establish whether referral for MR scan is appropriate and to draw up a priority scale for access to MR diagnosis. If MR investigation is deemed inappropriate, the project provides for an alternative procedure or specialist clinical examination. The patient is admitted to the charge of the service and followed throughout the diagnostic work-up, i.e. the doctor undertaking the assessment will prescribe a possible specialist clinical consultation or other radiological procedures, generally CT scans performed by the same Radiology or Neuroradiology unit. We report on neuroradiological assessment of referrals for brain MR scans on behalf of the Public Health Service and carried out at the Neuroradiology Unit in Bellaria Hospital, Bologna. From 1st November to 31st July 2004, 2659 assessments were undertaken. Of these 2163 were approved for MR scanning whereas 496 referrals were modified, mostly into CT scans and some patients were referred for otorhinolaringology, endocrinology or neurology specialist consultation. To assess the impact of this “filter”, we compared a sample period of six months from 1st February 2003 to 31st July 2003 before the radiological assessment project had been implemented with a period of the same length the following year. We found that the number of negative MR scans was halved after the project had been implemented (from 24.49% in 2003 to 12.18% in 2004), showing that in addition to shortening waiting lists for MR scans, there has been a sharp rise in the number of appropriate scans.

scholarly journals INFORMED CONSENT DALAM PELAYANAN KESEHATAN

2012 ◽  
Vol 5 (2) ◽  
pp. 309-318
Author(s):  
Adriana Pakendek Adriana Pakendek
Keyword(s):  
Public Health ◽  
Informed Consent ◽  
Health Service ◽  
Key Words ◽  
Public Health Service ◽  
Medical Patients ◽  
Key Words Informed Consent ◽  
The Future

Abstract:   It is a must to apply the informed consent in public health service, particularly in a hosptal. As a matter of fact, some medical patients or the  representative does not comprehend the term informed consent due to the ineffective communication between the patient and physician. Whereas, a doctor should have a legal informed consent to execute medical action from the patient, otherwise she/he would experience a question of law; private and punitive law as well as indisciplinary punishment. A petient is able to deny an informed consent, yet it is identified as an informed refusal. However, the patient must be responsible for any medical impacts in the future. In this case, a doctor is free from any legal actions as the result of consent refusal of patient.   Key Words: informed consent, pasien dan dokter

scholarly journals ISTCs: College to audit patient outcomes

2007 ◽  
Vol 89 (9) ◽  
pp. 304-305
Author(s):  
Elaine Towell
Keyword(s):  
Health Service ◽  
Patient Outcomes ◽  
Media Coverage ◽  
Waiting Times ◽  
Waiting Lists ◽  
Patient Choice ◽  
Operating Theatre ◽  
Cherry Picking ◽  
Independent Sector

Independent sector treatment centres (ISTCs) have proved controversial since they were brought into the health service in 2003 to meet the government's ambitious targets for reducing waiting lists to 18 weeks from GP referral to the operating theatre. Extensive media coverage on ISTCs has focused on both the positives: shorter waiting times and patient choice; and the negatives, accusing them of 'cherry-picking' the easiest patients, depriving the NHS of money and doctors of experience.

Measles Elimination

PEDIATRICS ◽  
1986 ◽  
Vol 77 (5) ◽  
pp. 790-790
Author(s):  
DAVID LEVY
Keyword(s):  
Public Health ◽  
United States ◽  
Health Service ◽  
Public Health Service ◽  
The United States ◽  
The Public ◽  
Measles Elimination ◽  
The Future ◽  
Future Challenges

To the Editor.— The Public Health Service deserves enormous credit for its campaign to eliminate measles in the United States. The recent review1 attests to this fact. I must, however, disagree with the conclusion of the article. The glaring omission is that measles is again on the increase. After a record low of 1,436 cases reported in 1983, 1984 saw an increase of about 69.3% to 2,534 cases, and 1985 will probably see more cases than 1984.2 The statement in the conclusion, "Although 2% to 10% of vaccinated persons will remain susceptible, there is no reason to believe that such individuals can lead to sustained transmission of measles in the United States," is totally unfounded and deters the pediatrician from the future challenges of measles.

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