scholarly journals Efficiency of Text Message Contact on Medical Safety in Outpatient Surgery: Retrospective Study (Preprint)

2019 ◽  
Author(s):  
Jeremy Peuchot ◽  
Etienne Allard ◽  
Bertrand Dureuil ◽  
Benoit Veber ◽  
Vincent Compère
Keyword(s):  
Conversion Rate ◽  
Outpatient Surgery ◽  
University Hospital ◽  
Controlled Study ◽  
Full Time ◽  
Medical Safety ◽  
Hospitalization Costs ◽  
Sms Reminder ◽  
Sms Reminders ◽  
The Impact

BACKGROUND Establishing pre- and postoperative contact with patients is part of successful medical management in outpatient surgery. In France, this is mostly done via telephone. Automated information with short message service (SMS) reminders might be an interesting alternative to increase the rate of compliance with preoperative instructions, but no study has shown the safety of this approach. OBJECTIVE The objective of this study was to evaluate the impact of pre- and postoperative automated information with SMS reminders on medical safety in outpatient surgery. METHODS We conducted a retrospective, single-center, nonrandomized, controlled study with a before-after design. All adult patients who had outpatient surgery between September 2016 and December 2017 in our university hospital center were included. Before April 2017, patients were contacted by telephone by an outpatient surgery nurse. After April 2017, patients were contacted by SMS reminder. All patients were contacted the day before and the day after surgery. Patients contacted by SMS reminder were also contacted on day 7 after surgery. The primary end point was the conversion rate to full-time hospitalization. Secondary end points were hospitalization causes (anesthetic, surgical, organizational) and hospitalization costs. RESULTS A total of 4388 patients were included, 2160 before and 2228 after the introduction of SMS reminders. The conversion rate to full-time hospitalization was 34/4388 (0.77%) with a difference between SMS group (8/2228, 0.36%) and telephone group (26/2160, 1.20%). The cost of SMS reminders was estimated as half that of telephone calls. CONCLUSIONS In this work, we report a decrease in the rate of conversion to full-time hospitalization with the use of pre- and postoperative SMS reminders. This new approach could represent a safe and cost-effective method in an outpatient surgery setting.

scholarly journals Efficiency of Text Message Contact on Medical Safety in Outpatient Surgery: Retrospective Study

10.2196/14346 ◽  
2020 ◽  
Vol 8 (9) ◽  
pp. e14346
Author(s):  
Jeremy Peuchot ◽  
Etienne Allard ◽  
Bertrand Dureuil ◽  
Benoit Veber ◽  
Vincent Compère
Keyword(s):  
Conversion Rate ◽  
Outpatient Surgery ◽  
University Hospital ◽  
Controlled Study ◽  
Full Time ◽  
Medical Safety ◽  
Hospitalization Costs ◽  
Sms Reminder ◽  
Sms Reminders ◽  
The Impact

Background Establishing pre- and postoperative contact with patients is part of successful medical management in outpatient surgery. In France, this is mostly done via telephone. Automated information with short message service (SMS) reminders might be an interesting alternative to increase the rate of compliance with preoperative instructions, but no study has shown the safety of this approach. Objective The objective of this study was to evaluate the impact of pre- and postoperative automated information with SMS reminders on medical safety in outpatient surgery. Methods We conducted a retrospective, single-center, nonrandomized, controlled study with a before-after design. All adult patients who had outpatient surgery between September 2016 and December 2017 in our university hospital center were included. Before April 2017, patients were contacted by telephone by an outpatient surgery nurse. After April 2017, patients were contacted by SMS reminder. All patients were contacted the day before and the day after surgery. Patients contacted by SMS reminder were also contacted on day 7 after surgery. The primary end point was the conversion rate to full-time hospitalization. Secondary end points were hospitalization causes (anesthetic, surgical, organizational) and hospitalization costs. Results A total of 4388 patients were included, 2160 before and 2228 after the introduction of SMS reminders. The conversion rate to full-time hospitalization was 34/4388 (0.77%) with a difference between SMS group (8/2228, 0.36%) and telephone group (26/2160, 1.20%). The cost of SMS reminders was estimated as half that of telephone calls. Conclusions In this work, we report a decrease in the rate of conversion to full-time hospitalization with the use of pre- and postoperative SMS reminders. This new approach could represent a safe and cost-effective method in an outpatient surgery setting.

scholarly journals Novel outpatient management of mild to moderate COVID-19 spares hospital capacity and safeguards patient outcome: The Geneva PneumoCoV-Ambu study

PLoS ONE ◽  
2021 ◽  
Vol 16 (3) ◽  
pp. e0247774
Author(s):  
Chloé Chevallier Lugon ◽  
Mikaela Smit ◽  
Julien Salamun ◽  
Meriem Abderrahmane ◽  
Olivia Braillard ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
Health Care Systems ◽  
University Hospital ◽  
High Rate ◽  
Ordinal Scale ◽  
Outpatient Management ◽  
Hospital Capacity ◽  
Hospitalization Costs ◽  
Novel Coronavirus ◽  
The Impact

Background Severe Acute Respiratory Coronavirus 2 (SARS-CoV-2), the novel coronavirus that causes coronavirus disease (COVID-19), is creating an unprecedented burden on health care systems across the world due to its high rate of pneumonia-related hospitalizations. This study presents recommendations for the outpatient management of moderate SARS-CoV-2 pneumonia implemented at the Geneva University Hospital, Switzerland, from April 4 to June 30, 2020 and evaluated the impact of these recommendations on patient safety, patient satisfaction, and overall hospital capacity. Methods Recommendations for the outpatient management of moderate pneumonia implemented in the Geneva University Hospital (PneumoCoV-Ambu) between April 4 and June 30, 2020, were evaluated prospectively. The primary endpoint was hospitalization. Secondary endpoints were: severity of COVID-19 disease based on a 7-points ordinal scale assessed at 1 and 2 months following SARS-CoV-2 infection; patient satisfaction using a satisfaction survey and the analysis of number of beds and costs potentially averted. Results A total of 36 patients with COVID-19-related pneumonia were followed between April 4 and May 5, 2020. Five patients (14%) were hospitalized and none died over a median of 30 days follow-up. The majority of patients (n = 31; 86%) were satisfied with the ambulatory care they received. These novel recommendations for outpatient management resulted in sparing an estimated potential 124 hospital bed-nights and CHF 6’826 per capita averted hospitalization costs over the three months period. Conclusions Recommendations developed for the outpatient management of COVID-19-related pneumonia were able to spare hospital capacity without increasing adverse patient outcomes. Widely implementing such recommendations is crucial in preserving hospital capacity during this pandemic.

scholarly journals Impact of home visits on the functional capacity of patients with venous ulcers

2017 ◽  
Vol 70 (2) ◽  
pp. 287-293 ◽  
Author(s):  
Fabiana Lopes Joaquim ◽  
Alessandra Conceição Leite Funchal Camacho ◽  
Rose Mary Costa Rosa Andrade Silva ◽  
Bruna Silva Leite ◽  
Raquel Santos de Queiroz ◽  
...  
Keyword(s):  
Functional Capacity ◽  
Wound Care ◽  
Home Visits ◽  
University Hospital ◽  
Controlled Study ◽  
Research Subjects ◽  
Evaluation Tool ◽  
Care Clinic ◽  
Venous Ulcers ◽  
The Impact

ABSTRACT Objective: to compare the impact of home visits, before and after instructions, on the functional capacity of adult and elderly patients with venous ulcers, by means of the KATZ-EIAVD Scale. Method: experimental, clinical, randomized, non-blind and controlled study, developed with 32 patients (case and control groups). The research settings were the Wound Care Clinic of the University Hospital Antonio Pedro, and the homes of patients assisted in this clinic. Data collection took place from February to June 2014, by means of a health unit evaluation tool, the KATZ-EIAVD Scale, and a script of instructions to be given to the research subjects that had received a home visit. Results: the studied population present excellent independence for activities of daily living, with no significant variation among them. Conclusion: the studied groups have functional capacity with similar progress.

scholarly journals Bedside POCUS during ward emergencies is associated with improved diagnosis and outcome: an observational, prospective, controlled study

Critical Care ◽  
2021 ◽  
Vol 25 (1) ◽  
Author(s):  
Laurent Zieleskiewicz ◽  
Alexandre Lopez ◽  
Sami Hraiech ◽  
Karine Baumstarck ◽  
Bruno Pastene ◽  
...  
Keyword(s):  
Point Of Care ◽  
Circulatory Failure ◽  
University Hospital ◽  
Controlled Study ◽  
Control Group ◽  
Point Of Care Ultrasound ◽  
Clinical Trial Registration ◽  
Ultrasound Device ◽  
Management Protocol ◽  
The Impact

Abstract Background Rapid response teams are intended to improve early diagnosis and intervention in ward patients who develop acute respiratory or circulatory failure. A management protocol including the use of a handheld ultrasound device for immediate point-of-care ultrasound (POCUS) examination at the bedside may improve team performance. The main objective of the study was to assess the impact of implementing such a POCUS-guided management on the proportion of adequate immediate diagnoses in two groups. Secondary endpoints included time to treatment and patient outcomes. Methods A prospective, observational, controlled study was conducted in a single university hospital. Two teams alternated every other day for managing in-hospital ward patients developing acute respiratory and/or circulatory failures. Only one of the team used an ultrasound device (POCUS group). Results We included 165 patients (POCUS group 83, control group 82). Proportion of adequate immediate diagnoses was 94% in the POCUS group and 80% in the control group (p = 0.009). Time to first treatment/intervention was shorter in the POCUS group (15 [10–25] min vs. 34 [15–40] min, p < 0.001). In-hospital mortality rates were 17% in the POCUS group and 35% in the control group (p = 0.007), but this difference was not confirmed in the propensity score sample (29% vs. 34%, p = 0.53). Conclusion Our study suggests that protocolized use of a handheld POCUS device at the bedside in the ward may improve the proportion of adequate diagnosis, the time to initial treatment and perhaps also survival of ward patients developing acute respiratory or circulatory failure. Clinical Trial Registration NCT02967809. Registered 18 November 2016, https://clinicaltrials.gov/ct2/show/NCT02967809.

scholarly journals The Impact of an Independent Sector Treatment Centre on Basic Surgical Training

2012 ◽  
Vol 94 (8) ◽  
pp. 276-278
Author(s):  
PG Vaughan-Shaw ◽  
SG Chiverton ◽  
DA Rew ◽  
PH Nichols
Keyword(s):  
Surgical Training ◽  
Medical Training ◽  
Substantial Reduction ◽  
University Hospital ◽  
Full Time ◽  
Surgical Trainees ◽  
Treatment Centre ◽  
Independent Sector ◽  
The Uk ◽  
The Impact

The reorganisation of postgraduate medical training in the UK as a result of Calman reforms, the New Deal and the implementation of the European workingTime regulations (EwTr) has led to a substantial reduction in working hours and a fall in operative experience for surgical trainees. The move of large volumes of minor and intermediate NHS surgical caseload into independently run hospitals and specialist centres (of which the Southampton NHS Treatment Centre, an independent sector treatment centre (ISTC) is a well-established example) has also radically altered the basic surgical training environment. The Southampton ISTC is run on contract by Care UK and is medically staffed by a mix of full-time Care UK employees from the UK and abroad as well as by visiting consultants from University Hospital Southampton NHS foundationTrust (UHSFT).

scholarly journals A technology-based nutritional education intervention to increase fruit and vegetables consumption in university students: findings from a randomised controlled study

2020 ◽  
Vol 79 (OCE2) ◽  
Author(s):  
Alyson Hill ◽  
Amin Hafiz ◽  
Alison Gallagher
Keyword(s):  
Vitamin C ◽  
University Students ◽  
Fast Food ◽  
Fruit And Vegetables ◽  
Controlled Study ◽  
Control Group ◽  
Full Time ◽  
Nutritional Education ◽  
Highly Active ◽  
The Impact

AbstractBackground:The transition to University is recognised as a vulnerable period for many young adults with the establishment of unhealthy eating behaviours. Evidence indicates that diets are low in fruit and vegetables, high in confectionary and fast food therefore, having the potential to develop obesity and long-term health implications. This RCT aimed to investigate the impact of providing 5 portions of fruit and vegetables (F&V) daily on consumption and plasma measurements. In addition to investigate whether intake was enhanced by nutritional education delivered using Facebook (FB)Methods:Sixty full-time university students (36 females, 24 males) were randomly assigned to one of 3 groups: F&V received five portions (80g) of fruit and vegetables daily for 4 weeks; F&V + FB received as for F&V group and in addition nutrition messages using FB; Control group maintained their usual diet. Compliance with F&V consumption was determined by analysis of vitamin C and carotenoid levels and in addition recorded intake and returned all uneaten F&V. Level of engagement on FB page was categorized according to interaction: highly active, somewhat active (interacts > once per month) or minimally active (interactsResults:Participants were aged 24.4 (SD 3.7) years and mean BMI of 25.4 (SD 4.7) kg/m2. Study groups did not differ by age, however they did differ by gender (24 male and 36 female, P = 0.003), BMI (P = < 0.039) and TEI (P = < 0.041). The number of portions of FV consumed increased in both intervention groups (P = < 0.001) and showed that 65% of participants increased intake of FV in both intervention groups (P = < 0.001) from baseline to end of study of 4.6 (0.6) F&V group, 4.7 (0.4) F&V + FB group. Mean change in serum β carotene was significantly higher for both intervention groups than the control group at the end of the four-week intervention period. However, the provision of F&V with or without FB did not have any enhanced effect on FV consumption and was not sustained at 3 weeks after the end of the intervention. Of those 20 participants in the F&V + FB group, 70% engaged with FB regularly with 35% classified as highly active, 15% moderately active and 50% minimally active.Conclusions:This study showed an increased consumption from 1.6 to 4.6 portions fruit and vegetables daily over the 4week study period and showed an increase in vitamin C and retinol levels. However, providing additional nutrition education via FB was insufficient to increase consumption.

Influence of Rings on the Efficacy of Hand Sanitization and Residual Bacterial Contamination

2007 ◽  
Vol 28 (3) ◽  
pp. 351-353 ◽  
Author(s):  
Montri D. Wongworawat ◽  
Sidney G. Jones
Keyword(s):  
Hand Hygiene ◽  
Povidone Iodine ◽  
Bacterial Count ◽  
University Hospital ◽  
Controlled Study ◽  
Randomized Controlled ◽  
Colony Forming Units ◽  
Significant Difference ◽  
The Impact ◽  
Number Of Bacteria

Background.Previous studies, conducted before widespread use of scrubless, alcohol-based hand sanitizers, demonstrated increased residual bacterial counts after hand hygiene on hands with jewelry.Objective.To compare the impact of finger rings on the effectiveness of scrubless and water-aided alcohol-based hand sanitization methods with that of povidone-iodine scrub.Design.Randomized, controlled study.Setting.University hospital.Participants.Sixty volunteer subjects from a pool of perioperative staff and medical students.Intervention.After recruitment, participants wore a ring on one hand and no ring on the other hand. They were randomly assigned to perform hand hygiene with a povidone-iodine scrub, an alcohol wash, or a waterless alcohol-chlorhexidine lotion (n = 20 subjects per method). After subjects completed hand hygiene, gloves were placed on their hands by means of sterile methods, and a “glove juice” technique was used to obtain samples for culture. The number of colony-forming units in each culture was counted, and the data were compared.Results.There was no significant difference in the number of bacteria between hands with and hands without rings for the groups that used alcohol wash or alcohol-chlorhexidine lotion. However, for the povidone-iodine group, the number of bacteria on hands with rings was greater than the number on hands without rings (P < .05). The hands of participants who used waterless alcohol-chlorhexidine had the lowest bacterial count, regardless of the presence of rings (P < .01).Conclusions.The presence of rings does not negatively impact the effectiveness of alcohol-based hand sanitizers. Use of waterless alcohol-chlorhexidine lotion resulted in the lowest bacterial count.

scholarly journals Effective methods for reactivating inactive blood donors: a stratified randomized controlled study

2019 ◽  
Author(s):  
Jian OU-YANG ◽  
Chun-Hua BEI ◽  
Hua-Qin LIANG ◽  
Bo HE ◽  
Jin-Yan CHEN ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Blood Donors ◽  
Average Treatment Effect ◽  
Controlled Study ◽  
Randomized Controlled ◽  
Donation Rate ◽  
Sms Reminder ◽  
Sms Reminders ◽  
Telephone Calls ◽  
Telephone Group

Abstract Background: Recruiting of sufficient numbers of donors of blood products is vital worldwide. In this study we assessed the efficacy and cost-effectiveness of telephone calls and SMS reminders for re-recruitment of inactive blood donors. Methods: This single-centre, non-blinded, parallel randomized controlled trial in Guangzhou, China included 11,880 inactive blood donors whose last donation was between January 1 and June 30, 2014. The donors were randomly assigned to one of two intervention groups (telephone call or short message service [SMS] communications) or to a control group without intervention. SMS messages with altruistic appeal were adopted in the SMS group; in addition to altruistic appeal, reasons for deferral of blood donation were also asked in the telephone group. All participants were followed up for 1 year. The primary outcome was re-donation rate, and rates in different groups were compared by intention-to-treat (ITT) analysis and estimation of the average treatment effect on the treated (ATT). Secondary outcomes were the self-reported deterrents. Other outcomes included the re-donation interval, and the incremental cost-effectiveness ratio (ICER) of telephone calls and SMS reminders on re-recruitment. Results: ITT analysis revealed no significant differences in the re-donation rate among the three groups. ATT estimations indicated that among compliers, telephone calls significantly increased re-donation compared to both SMS reminders and no intervention. Donor return behaviour was positively associated with receiving reminders successfully, being male, older age, and previous donation history. The SMS reminder prompted donors to return sooner than no reminder within 6 months, and according to ICER calculations, SMS reminders were more cost-effective than telephone calls. Donors reported time constraints as the most main causes of self-deferral in the telephone group, and altruistic appeal had a positive effect on these donors. Conclusions: Interventions to reactivate inactive blood donors can be effective, with telephone calls prompting more donors to return but at a greater cost than SMS messages. SMS reminder with altruistic appeal can urge donors to re-donate sooner within 6 months than no reminder.

scholarly journals 1235. A Survey of Surgical Site Infection (SSI) Surveillance Practices in US Hospitals, and their Association with SSI Rates

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S445-S445
Author(s):  
Aurora E Pop-Vicas ◽  
Fay Osman ◽  
Nasia Safdar
Keyword(s):  
Colon Surgery ◽  
Data Sources ◽  
University Hospital ◽  
Bivariate Analysis ◽  
Full Time ◽  
Critical Access Hospitals ◽  
University Hospitals ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
The Impact

Abstract Background Current US hospital reimbursement models rely on self-reported SSI rates. The impact of variability in SSI surveillance on publicly reported SSI rates is unknown. Methods Cross-sectional survey to US hospitals administered during November 18 – 2/19 through the Association for Professionals in Infection Control. We assessed SSI surveillance practices, and asked for self-reported facility standardized infection ratios (SIR) for hysterectomy and colon surgeries. We performed bivariate analysis and used Kendall’s ranks correlation for trend analysis. Results Of the 2,851 hospitals surveyed, 491 (17.2%) responded. Table 1 shows facility descriptors. Critical Access Hospitals (OR 6.11 [3.12 – 11.750, P < 0.005) and Ambulatory Surgical Centers (OR 3.92 [1.68 – 8.64], P < 0.001) were more likely to have less than one full-time ICP. University Hospitals were more likely to have ≥4 ICPs (OR 12.15 [6.73 – 22.04, P < 0.001). The majority (83%) of the 477 respondents reported electronic software for SSI surveillance, with Epic (23%), Theradoc (22%), and Cerner (11%) as the most common packages used. Manual surveillance was more likely for Critical Access Hospitals (OR 2.80 [1.47 – 5.19], P < 0.001). University Hospitals were more likely to have higher rates in 2016 for colon surgery (P = 0.02) and hysterectomy (P = 0.002). Table 2 shows characteristics of SSI surveillance practices reported by study participants. Ambulatory Surgical Center ICPs were more likely to use reports from surgeons and/or surgical staff as the initial trigger for SSI surveillance. University Hospital ICPs were significantly more likely to spend increased time (mean hours/month 69.77 vs. 28.99, P < 0.001), and to use more data sources for SSI review (mean 4.58 vs. 3.99, P = 0.001). In our trend analyses, we found the number of data sources used for SSI surveillance to be positively associated with higher SSI rates: (KT =0.14, P = 0.028 for colon SIR in 2017; KT = 0.20, P = 0.009; KT = 0.25, P = 0.001 for hysterectomy SIR in 2016 and 2017, respectively). Conclusion SSI surveillance practices across US hospitals vary significantly, and rigorous surveillance methods are associated with higher SSI rates. Standardizing SSI surveillance is necessary to accurately capture SSI burden of disease. Disclosures All authors: No reported disclosures.

scholarly journals Effects of in-center daily hemodialysis upon mineral metabolism and bone disease in end-stage renal disease patients

2001 ◽  
Vol 119 (3) ◽  
pp. 105-109 ◽  
Author(s):  
Jocemir Ronaldo Lugon ◽  
Mauro Barros André ◽  
Maria Eugênia Leite Duarte ◽  
Simone Martins Rembold ◽  
Elisa de Albuquerque Sampaio da Cruz
Keyword(s):  
Bone Disease ◽  
Mineral Metabolism ◽  
Bone Lesion ◽  
University Hospital ◽  
Controlled Study ◽  
Daily Hemodialysis ◽  
Daily Dialysis ◽  
Bone Biopsies ◽  
The Impact ◽  
Conventional Hemodialysis

CONTEXT: Alternative hemodialysis schedules have been proposed to improve the quality of the dialysis. Nonetheless, their influence upon mineral and bone disorders is unknown. OBJECTIVE: To report the impact of a daily hemodialysis schedule upon the lesions of renal osteodystrophy. TYPE OF STUDY: Prospective non-controlled study. SETTING: Public University Hospital. PARTICIPANTS: Five patients treated by daily hemodialysis for at least 24 months. INTERVENTION: Daily dialysis sessions were accomplished with non-proportional dialysis machines without an ultrafiltration control device, with blood flow of 300 ml/min, bicarbonate dialysate ([Ca]=3.5 mEq/L) at 500 ml/min, and low-flux membrane dialyzers. Sessions were started at 6:00 p.m. (except Sundays) and lasted 2 hours. MAIN MEASUREMENTS: Serum levels of Ca and P from the last 6 months on conventional hemodialysis for the same patients were used for comparison with each semester of daily hemodialysis. Bone biopsies and PTH levels were obtained at the end of the conventional hemodialysis period and then again after 2 years of daily hemodialysis. RESULTS: Mean serum calcium was significantly higher during the second and third semesters of daily dialysis [10.0 mg% (SD 0.6), and 10.0 mg% (SD 0.8), respectively] compared to standard dialysis [9.4 mg% (SD 0.8)], p < 0.05. Mean values for phosphorus were significantly lower during every semester of daily hemodialysis [6.3 mg% (SD 1.8), 5.8 mg% (SD 1.7), 6.0 mg% (SD 1.7), and 6.0 mg% (SD 1.8)] compared to standard dialysis [7.2 mg% (SD 2.7)], P < 0.05. Variations in mean Ca x P product followed the same pattern as for phosphorus [59.5 (SD 16.0), 57.1 (SD 16.3), 59.8 (SD 17.7), and 58.31 (SD 20.9) vs. 68.6 (SD 27.3), P < 0.05]. After 2 years on daily hemodialysis, 2 patients who had aplastic lesion were found to have mild bone disorder. In addition, one patient with mixed bone lesion and moderate bone aluminum accumulation had osteitis fibrosa with no aluminum. Intact PTH values at the beginning of study and after 2 years on daily hemodialysis did not differ [134 pg/ml (SD 66) vs. 109 pg/ml (SD 26), P = 0.60, respectively]. CONCLUSIONS: Patients treated using daily hemodialysis had better control of serum phosphorus and perhaps a lower risk of metastatic calcifications. Daily hemodialysis also seemed to be beneficial to low turnover bone disease and bone aluminum deposition.

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