scholarly journals Assessing the engagement in a post-discharge phone Follow-Up project

ABOUTOPEN ◽  
2020 ◽  
Vol 7 (1) ◽  
pp. 38-42
Author(s):  
Giuliana Pitacco ◽  
Ramiro Mendoza-Maldonado ◽  
Sandro Centonze
Keyword(s):  
Social Services ◽  
Third Sector ◽  
Pilot Project ◽  
Community Services ◽  
Post Discharge ◽  
Self Assessment ◽  
Rehabilitation Facility ◽  
Use Of Services ◽  
The City

Introduction: The article describes a post-discharge telephone Follow-Up pilot project that was activated in 2018 in the city of Trieste. Methods: The pilot project, in addition to the interception of possible situations of discomfort to be reported to social services and to ensure informative support to guide people to an optimal use of services, aimed to investigate the conditions, 1 and 3 months after discharge, of people not followed by the community services, in particular: a) maintenance of functional capacity; b) self-assessment of the patient with respect to health conditions and level of engagement; c) state of the relationships network; d) use of public, private and/or third sector health or welfare resources. Results and Conclusions: The Telephone Follow-Up has made it possible to experiment a “light” way of taking care of people discharged from a hospital or rehabilitation facility, to intercept situations of discomfort, reporting them to the Local District and social services and facilitating the appropriate use of local assistance services.

scholarly journals Weathering the storm: A qualitative study of social prescribing in urban and rural Scotland during the COVID-19 pandemic

2021 ◽  
Vol 9 ◽  
pp. 205031212110291
Author(s):  
Alison Fixsen ◽  
Simon Barrett ◽  
Michal Shimonovich
Keyword(s):  
Urban Areas ◽  
Third Sector ◽  
Community Services ◽  
Clinical Approach ◽  
Community Based ◽  
Online Delivery ◽  
Social Distancing ◽  
Social Prescribing ◽  
And Shifts

Objectives: The non-clinical approach known as social prescribing aims to tackle multi-morbidity, reduce general practitioner (GP) workload and promote wellbeing by directing patients to community services. Usual in-person modes of delivery of social prescribing have been virtually impossible under social distancing rules. This study qualitatively examined and compared the responses of three social prescribing schemes in Scotland to the COVID-19 pandemic. Methods: We interviewed a theoretical sample of 23 stakeholders in urban and rural social prescribing schemes at the start of COVID-19 pandemic. Follow-up interviews with a representative sample were conducted around 10 months later. Interviewees included social prescribing coordinators (SPCs) GPs, managers, researchers and representatives of third sector organizations. Interview transcripts were analysed in stages and an inductive approach to coding was supported by NVivo. Results: Findings revealed a complex social prescribing landscape in Scotland with schemes funded, structured and delivering services in diverse ways. Across all schemes, working effectively during the pandemic and shifting to online delivery had been challenging and demanding; however, their priorities in response to the pandemic had differed. With GP time and services stretched to limits, GP practice-attached ‘Link Workers’ had taken on counselling and advocacy roles, sometimes for serious mental health cases. Community-based SPCs had mostly assumed a health education role, and those on the Western Isles of Scotland a digital support role. In both rural or urban areas, combatting loneliness and isolation – especially given social distancing – remained a pivotal aspect of the SPC role. Conclusion: This study highlights significant challenges and shifts in focus in social prescribing in response to the pandemic. The use of multiple digital technologies has assumed a central role in social prescribing, and this situation seems likely to remain. With statutory and non-statutory services stretched to their limits, there is a danger of SPCs assuming new tasks without adequate training or support.

Schizophrenic Patients Discharged from Hospital—A Follow-up Study

1984 ◽  
Vol 145 (6) ◽  
pp. 586-590 ◽  
Author(s):  
Eve C. Johnstone ◽  
David G. C. Owens ◽  
Aviva Gold ◽  
Timothy J. Crow ◽  
J. Fiona Macmillan
Keyword(s):  
Social Services ◽  
Hospital Care ◽  
Mental Hospital ◽  
Mental States ◽  
Community Services ◽  
Follow Up Study ◽  
Financial Difficulties ◽  
Schizophrenic Patients ◽  
Psychotic Features

SummaryA cohort of 120 patients, comprising all those who met the St Louis criteria for a diagnosis of schizophrenia, discharged from a mental hospital over a five-year period, were followed-up in the community after an interval of five to nine years; 105 were traced and 94 were alive. Of those, 66 were living in UK, out of hospital, and willing to be seen. Their mental states, and social functioning and circumstances were assessed by interview with the patients and those with whom they lived; 18% had recovered to the extent that they had no significant symptoms and appeared to function satisfactorily. More than 50% had definite psychotic features. No patients and few relatives sought a return to hospital care, but severe emotional, social, and financial difficulties were commonplace; 27% of the sample had no contact with medical or social services, a further 14% saw only community nurses, and 24% only their general practitioners. The findings emphasise the limitations of community services in dealing with the chronicity and severity of the impairments resulting from schizophrenic illness.

scholarly journals Data linkage in social care: a pilot project

2017 ◽  
Vol 1 (1) ◽  
Author(s):  
Alison Orrell ◽  
Martin Heaven ◽  
Diane Seddon ◽  
Catherine Robinson
Keyword(s):  
Social Services ◽  
Service Provision ◽  
Social Care ◽  
Data Linkage ◽  
Local Authority ◽  
Third Sector ◽  
Pilot Project ◽  
Complete Picture ◽  
Third Sector Organisations ◽  
Discharge From Hospital

ABSTRACT BackgroundTo build the complete picture of service provision there is a need to broaden the linked data available to include health, social service provision by Local Authorities, and provision of support by third sector organisations. Data Linkage in Social Care is a pilot project to test the feasibility of linking datasets from a local authority, the NHS and third sector organisations. The focus of this work is individual level data from adults who are referred to social services in order to avoid admission to hospital or to facilitate their discharge from hospital. The data linkage will include data from statutory and third sector organisations and services which provide interventions and support in community settings. ObjectivesThe main aims of this research are to:1. Test the feasibility of linking datasets from Local Authority, the NHS and third sector organisations.2. Build a more complete picture of service provision using adults who have been referred to social services in order to avoid admission to hospital or to facilitate their discharge from hospital.3. Assess the range and quality of data available in each of the relevant organisations providing services to those individuals. The research outcome is a better understanding of the utility of data linkage across statutory and third party organisations. ApproachA Bangor University led research team partnered with the Gwynedd Local authority to explore the Governance Issues and practicalities of providing an anonymised dataset to the SAIL databank at Swansea. Two third sector agencies were also approached. With the various required Service Level Agreements in place, data were put through the tried and trusted SAIL process for analysis. Results Data relating to well over 20,000 referrals generated by 17,000+ social services clients in Gwynedd Local Authority from the period 2008 to 2015 were anonymised into the SAIL databank in Swansea, and linked to records from primary and secondary care. We will present results on the success of this process and on the emerging findings from the linked datasets.

Ten-Year Prognosis of Conversion Disorder

1996 ◽  
Vol 169 (3) ◽  
pp. 282-288 ◽  
Author(s):  
C. J. Mace ◽  
M. R. Trimble
Keyword(s):  
Neurological Disease ◽  
Conversion Disorder ◽  
Structured Interview ◽  
Community Services ◽  
Screening Criteria ◽  
Somatisation Disorder ◽  
Use Of Services ◽  
Poor Outcomes ◽  
Hospital Contact

BackgroundPrevious work suggests neurological disease commonly supervenes in cases of conversion disorder but has not identified clear predisposing factors. Patients' subsequent use of services has been neglected.MethodClinical outcomes for 73 patients investigated for pseudoneurological symptoms at a neurological hospital 10 years earlier were compared with findings on presentation. Fifty-six patients complied with a structured interview concerning use of services.ResultsThirty patients had no relief from their original symptom at follow-up. They had been older, with more chronic symptoms, and different auxiliary psychiatric diagnoses. In 11 patients a clear neurological diagnosis was subsequently made for the original symptom. Provisional neurological diagnoses at presentation had been disproportionately common among these 11. Small numbers of patients with poor outcomes made most use of hospital and community services. High attenders met screening criteria for somatisation disorder at follow-up.ConclusionsThe prognosis for chronic symptoms remains poor, but subsequent rediagnosis of neurological disease is less frequent than commonly supposed. Somatisation disorder may develop if hospital contact does not lead to diagnosis of another disease.

scholarly journals El Profesorado Técnico de Servicios a la Comunidad: ámbitos y temas de intervención

2021 ◽  
pp. 57-68
Author(s):  
Laura Paredes Galiana
Keyword(s):  
Secondary School ◽  
Social Services ◽  
Work Practice ◽  
School Dropout ◽  
Community Services ◽  
Discussion Groups ◽  
Daily Work ◽  
The Family ◽  
The Subject

El siguiente artículo aborda al Profesorado Técnico de Servicios a la Comunidad en los centros educativos públicos de educación secundaria en la Región de Murcia. En palabras de Paredes (2020) el PTSC es un profesional de la educación y agente dinamizador, sirviendo de puente entre el centro educativo de secundaria, la familia, el alumnado y la sociedad. Los objetivos establecidos en el presente artículo, son: conocer las tareas reales del PTSC y analizar las relaciones coherentes o no, existentes entre las tareas oficialmente reguladas y las que desarrollan los PTSC en la realidad educativa. Debido a las características de la muestra así como a la escasa bibliografía en el tema, se ha optado por una metodología mixta en donde se complementa el uso de cuestionarios, entrevistas y grupo de discusión. Como resultados, entre otros, se ha obtenido que el PTSC en la Región de Murcia ejerce como funciones reuniones y seguimientos con familias, coordinación con Servicios Sociales, colaboración con los tutores y tutoras, control del absentismo escolar, fracaso académico y abandono escolar , y por último, mejora de la convivencia y no violencia. Otro resultado a destacar, es que el 55,7% de los encuestados afirma que hay diferencias entre lo que deberían hacer según la normativa y lo que hacen en la práctica laboral diaria. Para finalizar, como conclusión se puede sintetizar en que las tareas asignadas legalmente y las realizadas en la práctica laboral diaria son coincidentes, aunque con matices, y que estas situaciones son múltiples, diversas y complejas. The following article deals with the Technical Teacher of Community Services in public secondary schools in the Region of Murcia. In the words of Paredes (2020), the PTSC is an educational professional and a dynamic agent, who serves as a bridge between the secondary school, the family, the students and society. The objectives established in this article are: to know the real tasks of the PTSC and to analyse the coherent or non-existent relationships between the officially regulated tasks and those developed by the PTSC in the educational reality. Due to the characteristics of the sample as well as the scarce bibliography on the subject, a mixed methodology has been chosen, complementing the use of questionnaires, interviews and discussion groups. As results, among others, it has been obtained that the PTSC in the Region of Murcia has the following functions: meetings and follow-up with families, coordination with Social Services, collaboration with tutors, control of truancy, school failure and school dropout and, finally, improvement of coexistence and non-violence. Another noteworthy result is that 55.7% of those surveyed stated that there are differences between what they should do according to the regulations and what they do in their daily work practice. Finally, as a conclusion, it can be summarised that the legally assigned tasks and those carried out in daily work practice coincide, although with nuances, and that these situations are multiple, diverse and complex.

scholarly journals A Proposal for Multidisciplinary Tele-Rehabilitation in the Assessment and Rehabilitation of COVID-19 Survivors

2020 ◽  
Vol 17 (13) ◽  
pp. 4890 ◽  
Author(s):  
Abayomi Salawu ◽  
Angela Green ◽  
Michael G. Crooks ◽  
Nina Brixey ◽  
Denise H. Ross ◽  
...  
Keyword(s):  
Care Pathway ◽  
Community Services ◽  
The Body ◽  
Post Discharge ◽  
Rehabilitation Team ◽  
Multidisciplinary Rehabilitation ◽  
Organ Systems ◽  
Specialist Rehabilitation ◽  
Medical Teams

A global pandemic of a new highly contagious disease called COVID-19 resulting from coronavirus (severe acute respiratory syndrome (SARS)-Cov-2) infection was declared in February 2020. Though primarily transmitted through the respiratory system, other organ systems in the body can be affected. Twenty percent of those affected require hospitalization with mechanical ventilation in severe cases. About half of the disease survivors have residual functional deficits that require multidisciplinary specialist rehabilitation. The workforce to deliver the required rehabilitation input is beyond the capacity of existing community services. Strict medical follow-up guidelines to monitor these patients mandate scheduled reviews within 12 weeks post discharge. Due to the restricted timeframe for these events to occur, existing care pathway are unlikely to be able to meet the demand. An innovative integrated post-discharge care pathway to facilitate follow up by acute medical teams (respiratory and intensive care) and a specialist multidisciplinary rehabilitation team is hereby proposed. Such a pathway will enable the monitoring and provision of comprehensive medical assessments and multidisciplinary rehabilitation. This paper proposes that a model of tele-rehabilitation is integrated within the pathway by using digital communication technology to offer quick remote assessment and efficient therapy delivery to these patients. Tele-rehabilitation offers a quick and effective option to respond to the specialist rehabilitation needs of COVID-19 survivors following hospital discharge.

Students Involvement in Multilingual and Multicultural Community Services

2015 ◽  
Vol 22 (2) ◽  
pp. 77-89 ◽  
Author(s):  
Ying-Chiao Tsao
Keyword(s):  
Service Learning ◽  
Cultural Competence ◽  
Linguistically Diverse ◽  
Community Services ◽  
Cultural Humility ◽  
Self Assessment ◽  
Multicultural Community ◽  
Raising Awareness ◽  
Hands On ◽  
Teaching Learning

Promoting cultural competence in serving diverse clients has become critically important across disciplines. Yet, progress has been limited in raising awareness and sensitivity. Tervalon and Murray-Garcia (1998) believed that cultural competence can only be truly achieved through critical self-assessment, recognition of limits, and ongoing acquisition of knowledge (known as “cultural humility”). Teaching cultural humility, and the value associated with it remains a challenging task for many educators. Challenges inherent in such instruction stem from lack of resources/known strategies as well as learner and instructor readiness. Kirk (2007) further indicates that providing feedback on one's integrity could be threatening. In current study, both traditional classroom-based teaching pedagogy and hands-on community engagement were reviewed. To bridge a gap between academic teaching/learning and real world situations, the author proposed service learning as a means to teach cultural humility and empower students with confidence in serving clients from culturally/linguistically diverse backgrounds. To provide a class of 51 students with multicultural and multilingual community service experience, the author partnered with the Tzu-Chi Foundation (an international nonprofit organization). In this article, the results, strengths, and limitations of this service learning project are discussed.

Post Discharge Clinically Overt Venous Thromboembolism in Orthopaedic Surgery Patients with Negative Venography -an Overview Analysis

1996 ◽  
Vol 76 (06) ◽  
pp. 0887-0892 ◽  
Author(s):  
Serena Ricotta ◽  
Alfonso lorio ◽  
Pasquale Parise ◽  
Giuseppe G Nenci ◽  
Giancarlo Agnelli
Keyword(s):  
Venous Thromboembolism ◽  
Orthopaedic Surgery ◽  
Diagnostic Methods ◽  
Future Research ◽  
Post Discharge ◽  
Pharmacological Prophylaxis ◽  
Vein Thrombosis ◽  
Overview Analysis ◽  
Major Orthopaedic Surgery

SummaryA high incidence of post-discharge venous thromboembolism in orthopaedic surgery patients has been recently reported drawing further attention to the unresolved issue of the optimal duration of the pharmacological prophylaxis. We performed an overview analysis in order to evaluate the incidence of late occurring clinically overt venous thromboembolism in major orthopaedic surgery patients discharged from the hospital with a negative venography and without further pharmacological prophylaxis. We selected the studies published from January 1974 to December 1995 on the prophylaxis of venous thromboembolism after major orthopaedic surgery fulfilling the following criteria: 1) adoption of pharmacological prophylaxis, 2) performing of a bilateral venography before discharge, 3) interruption of pharmacological prophylaxis at discharge in patients with negative venography, and 4) post-discharge follow-up of the patients for at least four weeks. Out of 31 identified studies, 13 fulfilled the overview criteria. The total number of evaluated patients was 4120. An adequate venography was obtained in 3469 patients (84.1%). In the 2361 patients with negative venography (68.1%), 30 episodes of symptomatic venous thromboembolism after hospital discharge were reported with a resulting cumulative incidence of 1.27% (95% C.I. 0.82-1.72) and a weighted mean incidence of 1.52% (95% C.I. 1.05-1.95). Six cases of pulmonary embolism were reported. Our overview showed a low incidence of clinically overt venous thromboembolism at follow-up in major orthopaedic surgery patients discharged with negative venography. Extending pharmacological prophylaxis in these patients does not appear to be justified. Venous thrombi leading to hospital re-admission are likely to be present but asymptomatic at the time of discharge. Future research should be directed toward improving the accuracy of non invasive diagnostic methods in order to replace venography in the screening of asymptomatic post-operative deep vein thrombosis.

Conquering the Public Space

2018 ◽  
Author(s):  
Samuel Llano
Keyword(s):  
Public Space ◽  
Social Services ◽  
Social Groups ◽  
Public Image ◽  
Working Classes ◽  
The Public ◽  
San Bernardino ◽  
The City

This chapter presents an account of the San Bernardino band as the public facade of that workhouse. The image of children who had been picked up from the streets, disciplined, and taught to play an instrument as they marched across the city in uniform helped broadcast the message that the municipal institutions of social aid were contributing to the regeneration of society. This image contrasted with the regime of discipline and punishment inside the workhouse and thus helped to legitimize the workhouse’s public image. The privatization of social aid from the 1850s meant that the San Bernardino band engaged with a growing range of institutions and social groups and carried out an equally broad range of social services. It was thus able to serve as the extension through which Madrid’s authorities could gain greater intimacy with certain population sectors, particularly with the working classes.

scholarly journals Impact of pharmacist-conducted anticoagulation patient education and telephone follow-up on transitions of care: a randomized controlled trial

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Lamis R. Karaoui ◽  
Elsy Ramia ◽  
Hanine Mansour ◽  
Nisrine Haddad ◽  
Nibal Chamoun
Keyword(s):  
Tertiary Care ◽  
Intervention Group ◽  
Bleeding Event ◽  
Transitions Of Care ◽  
Control Group ◽  
Published Data ◽  
Post Discharge ◽  
Readmission Rates ◽  
The Impact

Abstract Background There is limited published data in Lebanon evaluating the impact of supplemental education for anticoagulants use, especially DOACs, on clinical outcomes such as bleeding. The study aims to assess the impact of pharmacist-conducted anticoagulation education and follow-up on bleeding and readmission rates. Methods This study was a randomized, non-blinded interventional study conducted between August 2017 and July 2019 in a tertiary care teaching Lebanese hospital. Participants were inpatients ≥18 years discharged on an oral anticoagulant for treatment. Block randomization was used. The control group received the standard nursing counseling while the intervention group additionally received pharmacy counseling. Phone call follow-ups were done on day 3 and 30 post-discharge. Primary outcomes included readmission rates and any bleeding event at day 3 and 30 post-discharge. Secondary outcomes included documented elements of education in the medical records and reported mortality upon day 30 post-discharge. Results Two hundred patients were recruited in the study (100 patients in each study arm) with a mean age of 73.9 years. In the pharmacist-counseled group, more patients contacted their physician within 3 days (14% versus 4%; p = 0.010), received explicit elements of education (p < 0.001) and documentation in the chart was better (p < 0.05). In the standard of care group, patients were more aware of their next physician appointment date (52% versus 31%, p < 0.001). No difference in bleeding rates at day 3 and 30 post-discharge was observed between the groups. Conclusions Although pharmacist-conducted anticoagulation education did not appear to reduce bleeding or readmission rates at day 30, pharmacist education significantly increased patient communication with their providers in the early days post-discharge. Trial registration Lebanon Clinical Trial Registry LBCTR2020033424. Retrospectively registered. Date of registration: 06/03/2020.

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