scholarly journals Applying the vaginal approach for benign ovarian cystectomy: current evidence and future applications

2020 ◽  
Vol 6 (5) ◽  
pp. FSO470
Author(s):  
Nicolas Galazis ◽  
Stephanie Mappouridou ◽  
Srdjan Saso ◽  
Konstantinos Lathouras ◽  
Joseph Yazbek
Keyword(s):  
Patient Satisfaction ◽  
Return To Work ◽  
Surgical Complications ◽  
Length Of Hospital Stay ◽  
Current Evidence ◽  
Ovarian Cysts ◽  
Ovarian Cystectomy ◽  
Case Selection ◽  
Wide Acceptance ◽  
Potential Difficulty

Vaginal ovarian cystectomy has not gained wide acceptance owing to the potential difficulty in entering the cul-de-sac. We review the current evidence on vaginal approaches to benign ovarian cysts. Outcome measures of interest included time to return to work, patient satisfaction, surgical complications and length of hospital stay. Ten studies were included in this review and involving 525 patients. Vaginal ovarian cystectomy is overall safe and feasible in appropriately selected cases with no evidence of intrapelvic adhesions or endometriosis. These findings will need to be validated in appropriately powered studies, before reliable conclusions can be drawn. Furthermore, we emphasize the importance of ultrasound both preoperatively for case selection optimization and intraoperatively, as a means of guidance during posterior culdotomy.

scholarly journals A physiotherapy network provided with training, monitoring and support achieves improved return to work and health outcomes

2014 ◽  
Vol 9 ◽  
Author(s):  
Paul Coburn
Keyword(s):  
Patient Satisfaction ◽  
Return To Work ◽  
Health Outcomes ◽  
Current Evidence ◽  
Training Support ◽  
Work Related ◽  
Select Group ◽  
Accident Injuries ◽  
Research Organisations ◽  
Work And Health

Background: In 2007, the Health and Disability Strategy Group (HDSG) of the TAC and Victorian WorkCover Authority recognised an opportunity to improve scheme outcomes by working more closely with health disciplines. To investigate whether this was feasible, a pilot program was proposed with a select group of physiotherapists. Objectives: To determine whether a network of physiotherapists who were provided with training, monitoring and support could achieve improved outcome in return to work and health outcomes.Method: In 2008, 92 physiotherapists undertook a select tender process and then completed training in return to work, the HDSG's Clinical Framework and familiarisation of the compensation system for work related and motor accident injuries. The outcomes of this network physiotherapist program were evaluated internally and by three independent research organisations to determine 1) impact on return to work, 2) impact on health outcomes, 3) patient satisfaction and 4) satisfaction of the physiotherapist providing the service. Results: When compared to non-network physiotherapist, the network physiotherapists demonstrated improved return to work for clients, better health outcomes, and greater patient satisfaction. Therapist satisfaction was also higher within the network physiotherapists.Discussion: This body of work conducted on a pilot group of physiotherapists demonstrates improved outcomes in a number of important domains for the management of worker's and motor accident injuries. It indicates that there is a benefit for schemes in supporting clinical programs. Current evidence suggests that compensable patients have worse health outcomes than their non-compensable counterparts. There is a need to promote programs that are beneficial to patients, compensable schemes and providers. Further investigation is required to demonstrate this benefit on a larger scale.Conclusions: This study indicates that there may be opportunities to improve health outcomes by investment from compensable bodies in training, support and monitoring of specific health disciplines.

The Results of Carpal Tunnel Release: Open Versus Endoscopic Technique

1994 ◽  
Vol 19 (1) ◽  
pp. 14-17 ◽  
Author(s):  
S. BANDE ◽  
L. DE SMET ◽  
G. FABRY
Keyword(s):  
Patient Satisfaction ◽  
Return To Work ◽  
Carpal Tunnel ◽  
Carpal Tunnel Release ◽  
Endoscopic Technique ◽  
Open Release ◽  
Significant Difference ◽  
Open Versus ◽  
Portal Technique

We retrospectively compared two similar groups of patients who underwent either endoscopic decompression of the carpal tunnel (single portal technique, 44 patients) or open decompression (58 patients) during 1 year in our department. To find out whether there was any subjective difference between the results of the two techniques, we sent each patient a questionnaire and received a 95% response. No major complications occurred. Three endoscopic decompressions had to be abandoned, and open release was performed. We could not demonstrate any significant difference in relief of symptoms and return to work between the two groups. Patient satisfaction at 6 to 18 months follow-up was high with both techniques.

Patient satisfaction of telephone or video interpreter services compared with in-person services: a systematic review

2018 ◽  
Vol 42 (2) ◽  
pp. 168 ◽  
Author(s):  
Corey Joseph ◽  
Marie Garruba ◽  
Angela Melder
Keyword(s):  
Patient Satisfaction ◽  
Consumer Satisfaction ◽  
English Language ◽  
Ad Hoc ◽  
A Priori ◽  
Current Evidence ◽  
Cochrane Library ◽  
Interpreter Services ◽  
Interpreter Service ◽  
Google Search

Objective This review was conducted to identify and synthesise the evidence around the use of telephone and video interpreter services compared with in-person services in healthcare. Methods A systematic search of articles published in the English language was conducted using PubMed, EMBASE, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Cochrane Library, Database of Abstracts of Reviews of Effects (DARE), Joanna Briggs, Google Scholar and Google. Search terms included ‘interpreter’, ‘patient satisfaction’, ‘consumer satisfaction’ and ‘client satisfaction’. Any study that did not compare in-person interpreter services with either telephone or video interpreter services was excluded from analysis. Studies were screened for inclusion or exclusion by two reviewers, using criteria established a priori. Data were extracted via a custom form and synthesised. Results The database search yielded 196 studies, eight of which were included in the present review. The search using an Internet search engine did not identify any relevant studies. Of the studies included, five used telephone and three used video interpreter services. All studies, except one, compared levels of satisfaction regarding in-person interpretation and telephone or video interpretation. One study compared satisfaction of two versions of video interpretation. There is evidence of higher satisfaction with hospital-trained interpreters compared with ad hoc (friend or family) or telephone interpreters. There is no difference in satisfaction between in-person interpreting, telephone interpreting or interpretation provided by the treating bilingual physician. Video interpreting has the same satisfaction as in-person interpreting, regardless of whether the patient and the physician are in the same room. Higher levels of satisfaction were reported for trained telephone interpreters than for in-person interpreters or an external telephone interpreter service. Conclusions Current evidence does not suggest there is one particular mode of interpreting that is superior to all others. This review is limited in its translational capacity given that most studies were from the US and in a Spanish-speaking cohort. What is known about the topic? Access to interpreters has been shown to positively affect patients who are not proficient in speaking the local language of the health service. What does this paper add? This paper adds to the literature by providing a comprehensive summary of patient satisfaction when engaging several different types of language interpreting services used in healthcare. What are the implications for practitioners? This review provides clear information for health services on the use of language interpreter services and patient satisfaction. The current body of evidence does not indicate a superior interpreting method when patient satisfaction is concerned.

scholarly journals Risk Factors for Impaired Patient-Reported Satisfaction and Increased Length of Hospital Stay Following Hysterectomy on Benign Indications in Premenopausal Women: a Study From the Swedish National Register for Gynecological Surgery

2019 ◽  
Vol 80 (03) ◽  
pp. 288-299
Author(s):  
Ninnie Borendal Wodlin
Keyword(s):  
Risk Factors ◽  
Patient Satisfaction ◽  
Hospital Stay ◽  
Length Of Hospital Stay ◽  
Premenopausal Women ◽  
Gynecological Surgery ◽  
National Register ◽  
Logistic Regression Models ◽  
Patient Reported ◽  
The Impact

Abstract Introduction The aims of the study were to evaluate the impact of intra- and postoperative complications on satisfaction one year after hysterectomy for benign conditions, to determine risk factors for low patient satisfaction and to analyze whether complications were associated with the length of hospital stay. Material and Methods A retrospective study of 27 938 women from the Swedish National Register for Gynecological Surgery undergoing hysterectomy for benign conditions between January 2004 and June 2016. Data were obtained from prospectively collected pre-, peri- and postoperative forms. Statistical analyses were performed using multivariable logistic regression models. Crude and adjusted odds ratios and 95% confidence intervals are presented. Results More than 90% were satisfied with the hysterectomy. Dissatisfaction was associated with complications. Pelvic pain as indication, preoperatively having less expectations to get rid of symptoms or being alleviated from surgery, and current smoking were also risk factors for low patient satisfaction. Vaginal and abdominal subtotal hysterectomies were associated with high satisfaction. Occurrence of complications intra- and postoperatively before discharge was associated with increased length of hospital stay, as well as occurrence and severity of complications reported after discharge from hospital. Conclusions Complications were strongly associated with lower patient satisfaction. Preoperative expectations of surgery, indication, mode of surgery and life-style factors had impact on the satisfaction. Patient-centered information to ensure realistic expectations and prevention of complications seem to be essential to gain optimal patient satisfaction with surgery.

scholarly journals THE VULKAN TECHNIQUE: A NOVEL OSTOMY-CLOSURE TECHNIQUE THAT REDUCES COMPLICATIONS AND OPERATIVE TIMES

2017 ◽  
Vol 30 (2) ◽  
pp. 139-142 ◽  
Author(s):  
Felix KRENZIEN ◽  
Christian BENZING ◽  
Fabian HARDERS ◽  
Tido JUNGHANS ◽  
Gyurdhan RASIM ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Surgical Complications ◽  
Subcutaneous Tissue ◽  
Operating Time ◽  
Length Of Hospital Stay ◽  
Surgical Site Infections ◽  
Skin Incision ◽  
Colostomy Closure ◽  
Hartmann Procedure ◽  
Prolonged Hospital

ABSTRACT Background: Ostomy reversals remain at high risk for surgical complications. Indeed, surgical-side infections due to bacterial contamination of the stoma lead to revision surgery and prolonged hospital stay. Aim: To describe the novel vulkan technique of ostomy reversal that aims to reduce operative times, surgical complications, and readmission rates. Methods: Ostomy closure was performed using the vulkan technique in all patients. This technique consists of external intestinal closure, circular skin incision and adhesiolysis, re-anastomosis, and closure of the subcutaneous tissue in three layers, while leaving a small secondary wound through which exudative fluid can be drained. The medical records of enterostomy patients were retrospectively reviewed from our hospital database. Results: The vulkan technique was successfully performed in 35 patients mainly by resident surgeons with <5 years of experience (n=22; 62.8%). The ileostomy and colostomy closure times were 53 min (interquartile range [IQR], 41-68 min; n=22) and 136 min (IQR: 88-188 min; n=13; p<0.001), respectively. The median hospital stay was seven days (IQR: 5−14.5 days); the length of hospital stay did not differ between ileostomy and colostomy groups. Major surgical complications occurred only in patients who underwent colostomy closure following the Hartmann procedure (n=2); grade≥IIIb according Clavien-Dindo classification. Conclusion: The vulkan technique was successfully applied in all patients with very low rates of surgical-site infections. Off note, residents with limited surgical experience mainly performed the procedure while operating time was less than one hour.

scholarly journals Quality evaluation of workers’ compensation hospital in Korea

2014 ◽  
Vol 9 ◽  
Author(s):  
Jong-Uk Won
Keyword(s):  
Health Care ◽  
Occupational Health ◽  
Return To Work ◽  
Hospital Stay ◽  
Evaluation Method ◽  
Length Of Hospital Stay ◽  
Work Rate ◽  
Injured Workers ◽  
Workers Compensation ◽  
Occupational Health Care

Background: The length of hospital stay among occupationally injured workers was too long comparing to national health insurance patients in Korea. Also return-to-work rate was low comparing to other countries. The Korea Workers’ Compensation & Welfare (COMWEL) has tried to upgrade the quality of care workers’ compensation contract hospitals since several years. One of the tries was to evaluate the workers’ compensation contract hospitals. However, many hospitals argued the appropriateness of the hospital evaluation.Objectives: This study was performed to evaluate the appropriateness of the workers’ compensation contract hospital evaluation.Methods: The total number of 500 hospitals was selected to evaluate among about 5,500 contracts hospitals according to their size or the number of occupationally injured patients. The main evaluation items were hospital facilities and equipment, health personnel, including doctors, record keeping, appropriateness of hospital care, outcomes, including return-to-work, length of hospital stay, satisfaction, etc. Multiple logistic regression was performed to evaluate the appropriateness of the results of this hospital evaluation. The dependent variables were return-to-work rate and length of hospital stay and independent variables were severity of injured workers, disability rate, company size, etc.Results: The hospitals were classified three categories according to the evaluation score; high, middle, and low quality. The return-to-work rate of high-quality hospitals was significantly higher (odds ratio 1.81; CI 1.27 – 2.58) than others. However, the length of hospital stay was not different among them.Conclusion: Return-to-work rate is one of the useful indicators for evaluating the occupational health care. Even though these are preliminary results, this evaluation method for the occupational health care hospitals would be appropriate for the purpose. The more specific analysis should be needed.

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