scholarly journals Safe implementation of index telephone clinic appointments for patients with suspected lower gastrointestinal cancer with concurrent financial and environmental benefits.

2021 ◽  
Author(s):  
Kasun Wanigasooriya ◽  
Diwakar Sarma ◽  
Peter Woods ◽  
Paul O'Connor ◽  
Adrian Matthews ◽  
...  
Keyword(s):  
Waiting Times ◽  
District General Hospital ◽  
Environmental Benefits ◽  
Electronic Patient Records ◽  
Curative Intent ◽  
Detection Rates ◽  
Face To Face ◽  
The United Kingdom ◽  
Financial Benefits ◽  
The Impact

Aims: The COVID-19 pandemic led to hospitals in the United Kingdom substituting face-to-face (FtF) clinics with virtual clinic (VC) appointments. We evaluated the impact of virtual two-week wait (2-ww) lower gastrointestinal (LGI) consultations on stakeholders at a district general hospital in England. Methods: Patients undergoing index outpatient 2-ww LGI clinic assessment between 01/06/2019-31/10/2019 (FtF group) and 01/06/2020-31/10/2020 (VC group) were identified. Relevant data were obtained using electronic patient records. Compliance with national cancer waiting time targets (WTT) was assessed. Environmental and financial impact analyses were performed. Results: In total, 1531 patients were analysed (median age=70, male=852, 55.6%). Of these, 757 (49.4%) were assessed virtually via telephone; the remainder were seen FtF (n=774, 50.6%). Ninety two (6%, VC=44, FtF=48) patients had malignant pathology and 64 (4.2%) had colorectal cancer (CRC); of these, 46 (71.9%, VC=26, FtF=20) underwent treatment with curative intent. The median waiting times to index appointment, investigation and diagnosis were significantly lower following VC assessment (p<0.001). The cancer detection rates (p=0.749), treatments received (p=0.785) and median time to index treatment for CRC patients (p=0.156) were similar. A significantly higher proportion of patients were seen within two weeks of referral in the VC group (p<0.001). VC appointments saved patients a total of 9288 miles, 0.7 metric tonnes of CO2 emissions and £7482.97. Taxpayers saved £80,242.00 from VCs. No adverse events or complaints were reported in the VC group. Conclusion: Virtual 2-ww LGI clinics were effective, safe and were associated with tangible environmental and financial benefits for stakeholders.

scholarly journals Impact of COVID-19 on surgical services in a District General Hospital in the United Kingdom: benefits versus drawbacks

2021 ◽  
Vol 8 (2) ◽  
pp. 440
Author(s):  
Islam H. El-Abbassy ◽  
Hesham El-Hakim ◽  
Mei Kei Wong ◽  
Robert McIntyre
Keyword(s):  
General Hospital ◽  
District General Hospital ◽  
Remote Consultation ◽  
Face To Face ◽  
Surgical Services ◽  
The United Kingdom ◽  
Number Of Patients ◽  
Service Activity ◽  
The Uk ◽  
The Impact

Background: COVID-19 outbreak led to significant changes in health services worldwide. This study aimed to assess the impact of this outbreak on the surgical services in a small District General Hospital and to highlight any benefits that we can take forward.Methods: Data were collected retrospectively comparing the surgical service activity during the two months (April and May 2020) around the peak of COVID-19 first wave in the UK and the similar two-month period the year before when activity was at its usual pre-COVID level. A short questionnaire on the use and satisfaction of remote consultation was circulated to all hospital consultants.Results: The total number of patients presenting to the emergency department in all specialities almost halved during the COVID-19 crisis. The number of emergency surgical admissions decreased. All elective lists were cancelled and more patients were managed conservatively. In April and May 2020, 156 patients had outpatient surgical consultations. Only 14 of them were face-to-face, whereas the rest were done either by telephone or video calls. This is compared to 472 patients who had face-to-face consultations in April and May 2019. The results of the questionnaire showed that over 90% of the consultants felt telemedicine consultations were satisfactory and that they would have an important role in the future.Conclusions: COVID-19 had serious impacts on surgical services regarding cancellation of elective lists and prolongation of waiting time. Despite these drawbacks, the increased confidence with telemedicine services was a significant benefit. 

scholarly journals Student nurses’ experiences of incivility and the impact on learning and emotional wellbeing

2017 ◽  
Vol 8 (4) ◽  
pp. 102 ◽  
Author(s):  
Julie C. Vuolo
Keyword(s):  
Nursing Education ◽  
Interpretative Phenomenological Analysis ◽  
Student Nurses ◽  
Theory And Practice ◽  
Negative Consequences ◽  
Emotional Wellbeing ◽  
Face To Face ◽  
The United Kingdom ◽  
The Impact ◽  
The Invisible

Background: Incivility is the display of intimidating, rude, disruptive or undesirable behaviours. Incivility in nursing has the potential to impact on the learning environment, student wellbeing and patient outcomes. Although it is a globally recognised phenomenon, relatively little is known about it in the context of nurse education in the United Kingdom, where the students’ time is divided equally between theory and practice and a nurse mentor is allocated to each student when on clinical placement.Methods: A phenomenological qualitative design was used to explore the experiences of ten student nurses studying on a three year degree level pre-registration (pre-licensure) nursing programme. Data was collected by in-depth, semi-structured, face-to-face interviews which were tape-recorded and transcribed verbatim. Thematic analysis was conducted using Interpretative Phenomenological Analysis as a framework.Results: Student nurses can experience incivility in both classroom and clinical settings with negative consequences in terms of learning and personal wellbeing. Four superordinate (main) themes (Knowing-Not Knowing/Positioning/The Invisible Student/Distraction) were identified along with a further fifteen subordinate themes which included misuse, being nameless and feeling a burden.Conclusions: These findings add further to our understanding of incivility in nursing education and specifically the potential for incivility to impact on learning and students’ emotional wellbeing. Incivilities related to ‘the Invisible Student’ and ‘Knowing-Not Knowing’ are particularly worthy of further exploration as they reveal a hitherto unappreciated dimension of this complex, globally recognised phenomena. 

scholarly journals Financing entrepreneurship in times of crisis: Exploring the impact of COVID-19 on the market for entrepreneurial finance in the United Kingdom

2020 ◽  
Vol 38 (5) ◽  
pp. 380-390 ◽  
Author(s):  
Ross Brown ◽  
Augusto Rocha ◽  
Marc Cowling
Keyword(s):  
United Kingdom ◽  
Real Time ◽  
Entrepreneurial Finance ◽  
Time Data ◽  
Face To Face ◽  
Policy Interventions ◽  
The United Kingdom ◽  
Real Time Data ◽  
Start Ups ◽  
The Impact

This commentary explores the manner in which the current COVID-19 crisis is affecting key sources of entrepreneurial finance in the United Kingdom. We posit that the unique relational nature of entrepreneurial finance may make it highly susceptible to such a shock owing to the need for face-to-face interaction between investors and entrepreneurs. The article explores this conjecture by scrutinising a real-time data source of equity investments. Our findings suggest that the volume of new equity transactions in the United Kingdom has declined markedly since the outbreak of the COVID-19 pandemic. It appears that seed finance is the main type of entrepreneurial finance most acutely affected by the crisis, which typically goes to the most nascent entrepreneurial start-ups facing the greatest obstacles obtaining finance. Policy makers can utilise these real-time data sources to help inform their strategic policy interventions to assist the firms most affected by crisis events.

scholarly journals 909 ENT Telephone Clinic During COVID-19 Pandemic

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
N Sargsyan ◽  
D Karunaratne ◽  
A Masani ◽  
M Yousif
Keyword(s):  
Resource Allocation ◽  
Emergency Care ◽  
Waiting Times ◽  
District General Hospital ◽  
Telephone Consultation ◽  
Delay In Diagnosis ◽  
Face To Face ◽  
Cancer Pathways ◽  
Number Of Patients ◽  
Set Up

Abstract Introduction In response to the COVID-19 pandemic, ENT services in NHS hospitals have fundamentally changed the way they function. Focus is narrowed on emergency care and cancer care, with cancellation of most elective procedures. In response to this, 2 week wait (2ww) ENT telephone clinics were set up. This project reviewed the effectiveness of ENT telephone clinic appointments in managing 2ww referrals and to determine whether the introduction of 2ww telephone clinics improves patient waiting times and appropriates of referrals. Method Retrospective review of ENT telephone clinic 2ww referral outcomes at Eastbourne District General Hospital and the effectiveness of managing these patients. Results A total of 58 ENT Telephone Clinic 2ww referrals from the GP were reviewed. After a telephone consultation 63% of patients were referred to 2ww imaging, from which 70% were discharged following imaging. 83% of patient offered face to face appointment following imaging, required further investigation or treatment, again reducing delay in diagnosis. Conclusions Telephone clinic is an effective way of managing 2ww referral patients. In the ongoing pandemic, telephone clinics will be used to manage cancer pathways. This study shows that a large number of patients are discharged after imaging following a telephone clinic. Further study is required to determine whether low scoring patients on symptom-based risk calculators for cancer referrals could be directly referred to imaging to avoid delay in diagnosis, reduce anxiety as well as allow appropriate resource allocation.

A Simple Way to Improve DVT Protocol Compliance

2002 ◽  
Vol 16 (3) ◽  
pp. 121-124 ◽  
Author(s):  
M. E. Birks ◽  
S. Aiono ◽  
T. R. Magee ◽  
R. B. Galland
Keyword(s):  
Risk Factors ◽  
Deep Vein Thrombosis ◽  
Low Dose ◽  
District General Hospital ◽  
Vein Thrombosis ◽  
The United Kingdom ◽  
Raising Awareness ◽  
Protocol Compliance ◽  
Deep Vein ◽  
The Impact

Objective: To assess the impact on deep vein thrombosis (DVT) protocol violations of the introduction of a label attached to the patient's drug chart, which specifically allows low-dose subcutaneous heparin or thromboembolic deterrent stockings (TEDS) to be prescribed as appropriate. Design: An audit study. Setting: Department of General Surgery of a District General Hospital in the United Kingdom. Method: All adult general surgical inpatients on a Weekday were studied. Staff were not forewarned of the studies. Patient details and risk factors for DVT were noted. Details of administered DVT prophylaxis were recorded. In total four separate studies were undertaken, namely: with original protocols (I), with refined protocol 1 and 3 years later (II, III) and finally after introduction of the label (IV). Results: Protocol violations were defined as being ‘acceptable’ or ‘unacceptable’. Raising awareness between studies I and II reduced acceptable violations to zero. There was no statistically significant reduction in unacceptable violations (24 in 80 patients, 1; 17 in 75, II; 13 in 60, III). In study IV, following introduction of the label, there were only 6 violations in 51 patients ( p<0.02). Conclusion: Combining increased awareness with the attachment of a label to the drug chart reduced unacceptable violations by 63%.

scholarly journals Covid-19, Classical Subjects and the Classroom: Teachers’ Feedback from Summer 2020

2020 ◽  
Vol 21 (42) ◽  
pp. 60-65
Author(s):  
Jessica Dixon
Keyword(s):  
United Kingdom ◽  
The State ◽  
Classroom Teachers ◽  
Consultation Process ◽  
Face To Face ◽  
The United Kingdom ◽  
Classical Association ◽  
The Impact

AbstractThe Classical Association Teaching Board (CATB) surveyed Classics teachers in the United Kingdom from 20th August to 9th September 2020 to gauge views about the impact on teaching of the national lockdown during the covid-19 pandemic. 164 teachers from both the state and independent sectors completed the survey. There were three areas of focus in the survey. First, the impact on pupils of the grade awarding process after the cancellation of GCSE and A Level examinations in 2020. Second, how confident teachers were in preparing for the 2021 examinations after the loss of five months of face-to-face teaching. Third, reactions to Ofqual's consultation process on changes to the format of the 2021 examinations. This article brings together the responses to the survey and details how the unprecedented closure of schools affected the teaching of Classics. It will also explain how the CATB continues to support Classics teachers and the teaching of classical subjects in UK schools.

scholarly journals EP.WE.20At a glance: the impact of COVID-19 on Emergency General Surgery

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Mohamed Aboul-Enein ◽  
Peter Ishak ◽  
Maninder Bhambra ◽  
Pol Ricart ◽  
Lisa Ishak ◽  
...  
Keyword(s):  
General Surgery ◽  
District General Hospital ◽  
Patient Questionnaire ◽  
X Rays ◽  
Long Term Effects ◽  
Emergency General Surgery ◽  
Patient Behaviour ◽  
The United Kingdom ◽  
Retrospective Data Collection ◽  
The Impact

Abstract Aim This study investigated the impact of COVID-19 on emergency general surgery practice, in a district general hospital in the United Kingdom, particularly on referrals, diagnosis, investigations, management pathways, outcomes, patient behaviour and consultant practice. Methods Retrospective data collection from two cohorts: 112 patients admitted over one week in pre-COVID period and 90 patients admitted over one week during the COVID period. We used patient questionnaire and a consultant questionnaire to collect data on patient behaviour and consultant practice. Results Almost four times and seven times increase in performed X-rays (CXRs)and CT-thorax-abdomen-pelvis (TAPs) respectively. The COVID period saw 6.5% increase in conservative and 6.2% reduction in surgical management, and about 50% decline in length of stay (LoS) in conservatively managed patients. 71% of patients’ decisions to attend hospital were not affected and 78.6% of consultant surgeons preferred to manage patients conservatively during the COVID period. Conclusion Overall, there were delayed patients’ presentations to hospital at almost twice, increase in paediatric referrals, a surge in performed scans, and a reduction in hospital stay in patients who were managed conservatively. Patient behaviour to attend hospital was not heavily influenced by COVID, but consultant practice certainly changed towards more conservative choices. Future studies should explore the impact on paediatric referrals and long-term effects on surgical training. This study's manuscript has been accepted for publication in the Surgical Practice Journal.

E-Learning vs. Traditional Teaching Methods

2011 ◽  
pp. 174-178
Author(s):  
Chris Blackmore ◽  
Emmy van Deurzen ◽  
Diby Tantam
Keyword(s):  
Training Program ◽  
Psychotherapy Training ◽  
Practical Experience ◽  
European Countries ◽  
Family Work ◽  
Face To Face ◽  
The United Kingdom ◽  
E Learning ◽  
Self Assessments ◽  
The Impact

We have conducted a series of action research projects on elearning in recent years, funded by grants from the European Commission. The SEPT project (Tantam, 2001) showed that access to psychotherapy for those who are in most need is restricted in many European countries. Accessibility factors played a part in this, and the SEPTIMUS project was designed to widen accessibility to psychotherapy by increasing access to training for students who live in geographically isolated areas, who have family/work commitments or who have a disability. SEPTIMUS is a 1-year psychotherapy training program blending theoretical instruction and tutoring delivered by elearning methods with supervision, therapy and practical experience delivered face to face and local to one of the 16 participating training centers, located in one of eight European countries. The project was coordinated from the United Kingdom (UK), and the training program was available to students in Austria, Czech Republic, Ireland, Italy, Poland, Portugal, Romania and UK The impact of the training was evaluation by means of student self-assessments, participation, time spent on-site, tutor-marked assignments, tutor feedback, supervisor reports and student feedback. One hundred fifty-six students have completed the course, and we recruited an additional 61 students taking comparable but traditional face-to-face courses in three of our participating training institutes to act as educational controls. In this article, we present the results of a comparison between the elearning students and these educational controls.

Impact of ‘two-week wait’ referral pathway on the diagnosis, treatment and survival in upper and lower gastrointestinal cancers

2019 ◽  
Vol 95 (1127) ◽  
pp. 470-475 ◽  
Author(s):  
Matthew Fallon ◽  
Md Tanveer Adil ◽  
Kasim Ahmed ◽  
Douglas Whitelaw ◽  
Farhan Rashid ◽  
...  
Keyword(s):  
Waiting Times ◽  
Curative Treatment ◽  
Poor Survival ◽  
Term Survival ◽  
Emergency Presentation ◽  
The United Kingdom ◽  
Improvement In Survival ◽  
The Impact ◽  
Upper Gastrointestinal ◽  
Short Term Survival

BackgroundThe ‘two-week wait’(2WW) referral pathway was introduced in the United Kingdom to reduce waiting times for treatment of cancer. There has been a debate regarding the efficacy of 2WW pathway since its implementation.MethodsA singleinstitutional analysis of upper gastrointestinal(UGI) and lower gastrointestinal(LGI) malignancies treated between 1April 2015 and 31March 2017 was undertaken to analyse the impact of 2WWreferral pathway on the diagnosis, treatment and survival.Results2WW referral does not achieve an earlier diagnosis compared with non-2WW routes of referral in UGI (χ2(3)=2.6, p=0.458) and LGI (χ2(3)=0.884, p=0.829) malignancies. 2WW referral does not lead to an improvement in curative treatment in UGI (OR1.48, 95%CI0.68to3.21, p=0.321) and LGI (OR1.59, 95%CI0.97to2.62, p=0.067) malignancies. No improvement in survival is seen in UGI (HR0.99, 95%CI0.56to1.75, p=0.963) and LGI (HR1.10, 95%CI0.60to1.99, p=0.764) malignancies by virtue of 2WW referral. Emergency presentation is the most common presenting route in UGI malignancy(40%) and is associated with poor survival (HR0.55, 95%CI0.30to0.97, p=0.045).Non-emergency route of presentation is associated with higher rates of curative treatment in UGI malignancies (OR3.49, 95%CI1.57to7.76, p=0.002). Lower rate of curative treatment (OR 0.27, 95%CI0.16to0.43, p<0.001) and poor survival (HR0.44, 95%CI0.26to0.76, p=0.003) is also observed in emergency presentation of LGI malignancy(29%) which is the secondmost common route of presentation in this group.Conclusion2WW referral does not achieve early diagnosis nor does it lead to an improvement in the rate of curative treatment in UGI and LGI malignancies. No improvement in short-term survival is seen in UGI malignancies nor in LGI malignancies on multivariate analysis by virtue of 2WW referral.

Sign in / Sign up

Export Citation Format

Share Document