Assessing patient satisfaction with a microsuction service in general practice: a comparative study

BackgroundIn the UK, about 2.3 million people each year require intervention for wax impaction, while otitis externa accounts for just over 1% of general practice consultations. Aural microsuction of debris from the ear canal is a commonly performed procedure within the ear, nose, and throat (ENT) outpatient clinic. This article examines the patient acceptability of an aural microsuction service delivered in general practice.AimTo determine patient satisfaction following the introduction of a new microsuction service in general practice compared with a hospital-delivered service.Design & settingThis is a prospective comparative study in two rural general practices in Ireland and the emergency department (ED) of the Royal Victoria Eye and Ear Hospital (RVEEH), Dublin.MethodA 3-month period of data collection on usual care of 56 patients in general practice was followed by a 3-month period of GP-intervention data collection on 67 patients. Comparative data were collected on 37 patients who attended the RVEEH for the same intervention procedure. Patients completed a validated patient satisfaction questionnaire (PSQ-18).ResultsBoth general practice groups scored significantly higher in all seven aspects of medical care than the RVEEH cohort. Patients in the GP-intervention group scored significantly higher in terms of satisfaction with procedure technique compared with the usual care GP group.ConclusionThe provision of microsuction as a service in general practice confers as much or more patient satisfaction as the provision of the service in a hospital setting.

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Impact of Pharmacist-Led Diabetes Management in Primary Care Clinics

INNOVATIONS in pharmacy ◽

10.24926/iip.v9i2.985 ◽

2018 ◽

Vol 9 (2) ◽

pp. 17

Author(s):

Benjamin Pontefract ◽

Benjamin S. King ◽

Cynthia A. King ◽

David M Gothard

Keyword(s):

Primary Care ◽

Patient Satisfaction ◽

Usual Care ◽

Diabetes Management ◽

Intervention Group ◽

Control Group ◽

Original Research ◽

Diabetic Patients ◽

Primary Care Clinics ◽

The Impact

Purpose: Current literature supports that pharmacists effectively lower hemoglobin A1c (HbA1c) in diabetic patients. Little data exists on pharmacists’ effects on comorbidity management, patient satisfaction, or financial viability of these positions. This study looked to assess the impact of pharmacists on diabetes management compared to usual care. Methods: This multi-site, two-part study includes a retrospective chart review of patients referred to the pharmacist versus usual care within a large academic health system. The pharmacists collaborated under a consult agreement with primary care physicians. The second part of the study assessed patient satisfaction through an abbreviated CG-CAHPS survey. Results:A total of 206 patients with diabetes for an average of 12 years were included. The average patient age was 62 years with 60% of patients identifying as female and 81% as African-American. Patients were enrolled in a 2:1 fashion with 138 patients in the intervention group. Average baseline HbA1c was 10.1% in the intervention group and 9.3% in the control group (p= 0.0125). At 6 months, the mean change in HbA1c was -2.17% and 0.48% for the intervention and control groups respectively (p Conclusion: Pharmacists are effective at lowering HbA1c in primary care clinics, and patients were highly satisfied with these services. While direct revenue from this service did not meet cost, the pharmacist did positively affect outcomes that contribute to reimbursement. Treatment of Human Subjects: IRB review/approval required and obtained Type: Original Research

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Acceptability and use of glaucoma virtual clinics in the UK: a national survey of clinical leads

BMJ Open Ophthalmology ◽

10.1136/bmjophth-2017-000127 ◽

2018 ◽

Vol 3 (1) ◽

pp. e000127 ◽

Cited By ~ 15

Author(s):

Patrick J G Gunn ◽

Joanne R Marks ◽

Leon Au ◽

Heather Waterman ◽

Paul G D Spry ◽

...

Keyword(s):

Patient Safety ◽

Usual Care ◽

National Survey ◽

Lower Risk ◽

Response Rate ◽

Model Of Care ◽

Patient Acceptability ◽

Risk Patients ◽

The Uk ◽

Question Survey

ObjectiveThe purpose of this paper is to describe the findings of a national survey that aimed to estimate the proportion of Hospital Eye Service (HES) units using glaucoma virtual clinics, to determine how these services differ and to gauge clinicians’ views and opinions on the safety and acceptability of this model of care compared with usual care.Methods and analysisThis 12-question survey was disseminated nationally to 92 clinical lead consultant ophthalmologists using SurveyMonkey.ResultsThe response rate was 45.7%. There were 21 out of the total 42 respondents (50.0%) who were based at an NHS Trust where glaucoma virtual clinics were already being used and a further 9 (21.4%) were planning to establish one. Clinical leads largely rated efficiency and patient safety to be at least equivalent to usual care (92.9%) and 81.0% perceived glaucoma virtual clinics to be acceptable to patients. The main reasons for not running glaucoma virtual clinics were insufficient staff (71.4%) and inadequate space (47.6%). The majority of those running virtual clinics used this model of care for ‘lower risk’ patients such as ocular hypertensives (90.5%) and glaucoma suspects.ConclusionGlaucoma virtual clinics are employed by a large proportion of HES units, with many seeking to develop such services. Clinical leads largely rate efficiency, patient safety and the perception of patient acceptability to be at least equivalent to usual care.

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Effectiveness of a high volume injection as treatment for chronic Achilles tendinopathy: randomised controlled trial

BMJ ◽

10.1136/bmj.m3027 ◽

2020 ◽

pp. m3027

Author(s):

Arco C van der Vlist ◽

Robert F van Oosterom ◽

Peter L J van Veldhoven ◽

Sita M A Bierma-Zeinstra ◽

Jan H Waarsing ◽

...

Keyword(s):

Patient Satisfaction ◽

Placebo Group ◽

Confidence Interval ◽

Usual Care ◽

Controlled Trial ◽

Intervention Group ◽

Return To Sport ◽

High Volume ◽

Achilles Tendinopathy ◽

Secondary Outcomes

Abstract Objective To study whether a high volume injection without corticosteroids improves clinical outcome in addition to usual care for adults with chronic midportion Achilles tendinopathy. Design Patient and assessor blinded, placebo controlled randomised clinical trial. Setting Sports medicine department of a large district general hospital, the Netherlands. Participants 80 adults (aged 18-70 years) with clinically diagnosed chronic midportion Achilles tendinopathy and neovascularisation on ultrasonography. 39 were randomised to a high volume injection without corticosteroids and 41 to placebo. Interventions Participants were instructed to perform an exercise programme for 24 weeks (usual care) combined with one 50 mL high volume injection of saline and lidocaine (intervention group) or one 2 mL placebo injection of saline and lidocaine (placebo group) at baseline. Main outcome measures Primary outcome was pain and function assessed using the validated Victorian Institute of Sports Assessment-Achilles (VISA-A) questionnaire at 24 weeks (analysed using a generalised estimation equations model). Secondary outcomes were patient satisfaction, return to sport, degree of ultrasonographic Doppler flow, visual analogue scale on 10 hop test, power and flexibility of the gastrocnemius and soleus muscles, pain detect questionnaire for neuropathic pain, and pain coping inventory. Participants were evaluated at baseline and at 2, 6, 12, and 24 weeks. Results Only one participant (1%) was lost to follow-up. The estimated mean VISA-A score improved significantly, from 40.4 (95% confidence interval 32.0 to 48.7) at baseline to 59.1 (50.4 to 67.8) at 24 weeks in the high volume injection group and from 36.9 (27.1 to 46.8) to 58.5 (47.9 to 69.1) in the placebo group. The VISA-A score over time did not differ between the groups (adjusted between group difference at 24 weeks 0.5 points, 95% confidence interval −17.8 to 18.8). No significant between group differences were found for patient satisfaction (21/37 (57%) v 19/39 (49%) patients, P=0.50) and return to desired sport (15/29 (52%) v 19/31 (61%) patients active in sports, P=0.65) at 24 weeks. None of the other secondary outcomes differed between the two groups. Conclusions A high volume injection without corticosteroids in addition to usual care is not effective for symptom reduction in patients with chronic midportion Achilles tendinopathy. On the basis of our findings, we cannot recommend the use of a high volume injection in this patient group. Trial registration ClinicalTrials.gov NCT02996409

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Overseas GP recruitment: comparing international GP training with the UK and ensuring that registration standards and patient safety are maintained

BJGP Open ◽

10.3399/bjgpopen18x101640 ◽

2019 ◽

Vol 3 (2) ◽

pp. bjgpopen18X101640 ◽

Cited By ~ 1

Author(s):

Emily Fletcher ◽

Anna Sansom ◽

Emma Pitchforth ◽

Gerens Curnow ◽

Adrian Freeman ◽

...

Keyword(s):

General Practice ◽

Patient Safety ◽

Data Collection ◽

Continuing Professional Development ◽

Test Case ◽

European Economic Area ◽

Overseas Country ◽

The Uk ◽

Gp Training

BackgroundAmbitious overseas recruitment targets have been set by the UK government to help alleviate the current GP shortage. European Economic Area (EEA) doctors can join the UK’s GP register under European law. Non-EEA doctors must obtain a Certificate of Eligibility for General Practice Registration (CEGPR), demonstrating equivalence to UK-trained doctors. CEGPR applications can be time-consuming and burdensome. To meet overseas recruitment targets, it is important to facilitate the most efficient route into UK general practice while maintaining registration standards and patient safety.AimTo develop a methodology to map postgraduate GP training and healthcare contextual data from an overseas country to the UK.Design & settingDesk-based research and stakeholder interviews.MethodFour stages were undertaken: 1) developing a data collection template; 2) conducting a case study (using Australia as a test case); 3) refining the data collection template; and 4) creating a mapping framework. The case study used the 2016 curricula for the UK and Australia.ResultsFive ‘domains’ were identified: healthcare context, training pathway, curriculum, assessment, and continuing professional development (CPD) and revalidation. The final data collection template comprised 49 mapping items across the domains. The methodology incorporated the application of a red, amber, or green (RAG) rating to indicate similarity of data across the five domains. Australia was rated ‘green’ for training pathway, curriculum, and assessment, and ‘amber’ for healthcare context and CPD and revalidation. The overall rating was ‘green’.ConclusionImplementing this systematic methodology for mapping GP training between countries may support the UK’s ambitions to recruit more GPs, and alleviate current GP workforce pressures.

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Ethnic Differences in Self-Poisoning Across South London

Crisis ◽

10.1027/0227-5910/a000258 ◽

2014 ◽

Vol 35 (4) ◽

pp. 268-272

Author(s):

Sean Cross ◽

Dinesh Bhugra ◽

Paul I. Dargan ◽

David M. Wood ◽

Shaun L. Greene ◽

...

Keyword(s):

Black Women ◽

Data Collection ◽

White Women ◽

Population Based ◽

Care Services ◽

Self Harm ◽

Managing Risk ◽

The Uk ◽

Incident Cases ◽

Minority Ethnic

Background: Self-poisoning (overdose) is the commonest form of self-harm cases presenting to acute secondary care services in the UK, where there has been limited investigation of self-harm in black and minority ethnic communities. London has the UK’s most ethnically diverse areas but presents challenges in resident-based data collection due to the large number of hospitals. Aims: To investigate the rates and characteristics of self-poisoning presentations in two central London boroughs. Method: All incident cases of self-poisoning presentations of residents of Lambeth and Southwark were identified over a 12-month period through comprehensive acute and mental health trust data collection systems at multiple hospitals. Analysis was done using STATA 12.1. Results: A rate of 121.4/100,000 was recorded across a population of more than half a million residents. Women exceeded men in all measured ethnic groups. Black women presented 1.5 times more than white women. Gender ratios within ethnicities were marked. Among those aged younger than 24 years, black women were almost 7 times more likely to present than black men were. Conclusion: Self-poisoning is the commonest form of self-harm presentation to UK hospitals but population-based rates are rare. These results have implications for formulating and managing risk in clinical services for both minority ethnic women and men.

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