scholarly journals Perception, experience and knowledge of early physiotherapy in intensive care units of Rome: a survey

2020 ◽  
Vol 90 (4) ◽  
Author(s):  
Simone Salvitti ◽  
Elena Repossini
Keyword(s):  
Intensive Care ◽  
National Health Service ◽  
Health Service ◽  
National Health ◽  
Public Hospitals ◽  
Fundamental Aspect ◽  
Full Potential ◽  
Hospital Organization ◽  
Positive Effects ◽  
Clinical Instability

Early physiotherapy (EP) programs on critically ill patients in the intensive care unit (ICU) have proven to be safe, feasible and effective. However, despite being considered by all the professionals involved as a fundamental aspect of integrated care, in most cases they are inadequately applied or not performed at all. The main objective of this study is to evaluate the knowledge, perceptions and activities related to EP among physician, nurses and physiotherapists who practice in ICUs of Rome. Obstacles to its application and possible strategies to overcome them are also examined. The study was conducted according to the CHERRIES recommendations. Two questionnaires with 29 questions were created on the Google Form platform and were sent by mail to all the ICUs of public hospitals or accredited private hospitals with the National Health Service in Rome. Thirty (60%) of the contacted ICUs responded. The physiotherapist is present in 76.7% of ICUs and carries out its activities mainly during daytime hours (60.9%), for less than 3 hours in 39.1% of cases and only after a request for specialist advice (65.2%). Only in 4.3% of cases the service is guaranteed even at weekends but only after a request. All 29 professionals interviewed consider both the presence of a physiotherapist within the interdisciplinary team of the ICU and the implementation of an EP program to be necessary, supporting the positive effects of this program. The most frequently obstacles to the implementation of an EP program are clinical instability (69%), low priority to EP practice (62.1%), cardiovascular instability (58.6%) and lack of experience (58.6%). The most frequently indicated strategies to overcome these obstacles are to organize interdisciplinary briefings (86.2%), to avoid excluding patients from treatment without specific motivation (75.9%), to invest in staff training (75.9%), to use protocols and guidelines (58.6%). EP is not currently exploited to its full potential due to lack of funds, culture, experience, training and a hospital organization that limits the provision of effective patient care and efficient service to the National Health Service.

Strikes by Physicians in Public Hospitals in India

2000 ◽  
Vol 9 (4) ◽  
pp. 460-469 ◽  
Author(s):  
SUNIL K. PANDYA
Keyword(s):  
Health Insurance ◽  
National Health Service ◽  
Public Sector ◽  
Health Service ◽  
Medical Care ◽  
National Health ◽  
Public Hospitals ◽  
Teaching Hospitals ◽  
Tertiary Healthcare ◽  
The Subject

Can strikes by resident doctors training to become consultants in Indian public-sector teaching hospitals be ethical? These hospitals were established for the medical care of the very poor in a country where health insurance and a national health service are nonexistent. In such a situation, the paralysis of tertiary healthcare centers by striking doctors runs contrary to the raison d'être of the profession. It also violates the first dictum of medicine: Primum, non nocere. And although there is some discussion in the Western literature on strikes by doctors, authorities in India are silent on the subject.

scholarly journals Degree of control of physiciandiagnosed asthma and COPD in Italy

2016 ◽  
Vol 67 (1) ◽  
Author(s):  
G. Caramori ◽  
G. Bettoncelli ◽  
M. Carone ◽  
R. Tosatto ◽  
P. Di Blasi ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
National Health Service ◽  
Health Service ◽  
Emergency Room ◽  
National Health ◽  
Emergency Room Visits ◽  
Italian National Health Service ◽  
Italian National Health ◽  
Degree Of Control

Background. It is important for the Italian National Health Service to obtain data on the degree of control of asthma and chronic obstructive pulmonary disease (COPD) in the general population in Italy in order for balanced planning of future investments in these diseases to be made. Currently, precise estimates of these parameters are not available in literature. Objectives. In collaboration with the Italian Academy of General Practitioners (SIMG; www.simg.it) we have investigated the degree of control of physician-diagnosed asthma and COPD in Italy. Methods. A standardised questionnaire on asthma and COPD has been self-administered to a sample of 1937 Italian family physicians (representing around 5% of all the Italian doctors involved in general practice) chosen to cover all the Italian counties. Results. We have collected questionnaire data from 19,917 patients with asthma and COPD followed in their practice and 12,438 (62.4%) were correctly filled in enabling evaluation. We selected the number of emergency room visits, hospitalisations and intensive care unit admissions for asthma and COPD in the last 12 months as objective measures of the degree of asthma and COPD morbidity in these patients. The figures were respectively 12.4% (emergency room visits), 17.3% (hospitalisations) and 1.2% (intensive care unit admissions) of all patients with physician-diagnosed asthma and COPD. Conclusions. This data suggests that in Italy the morbidity of asthma and COPD remains high; representing a significant burden for the Italian National Health Service. There is a clear necessity for further studies to investigate the causes of this incomplete control.

scholarly journals A Endocrinologia em Portugal - Censo 2016. Direção do Colégio de Endocrinologia e Nutrição da Ordem dos Médicos

2017 ◽  
Vol 30 (9) ◽  
pp. 642
Author(s):  
Joana Guimarães ◽  
António Afonso ◽  
Davide Carvalho ◽  
Ana Paula Marques ◽  
Teresa Martins ◽  
...  
Keyword(s):  
National Health Service ◽  
Health Service ◽  
Medical Association ◽  
Human Resources ◽  
National Health ◽  
National Survey ◽  
Public Hospitals ◽  
The Other ◽  
European Countries ◽  
The Public

Introduction: On September 2016, the Board of the College of Endocrinology and Nutrition of the Portuguese Medical Association carried out a national survey, about all Endocrinology, Diabetes and Metabolism Departments of the public hospitals included in the Portuguese National Health Service and a simplified version of this survey was sent to all endocrinologists working in Portugal and registered with the Portuguese Medical Association.Material and Methods: Data related to organizational and human resources were collected, reporting the situation by the end of year 2015. The census registered 107 individuals and 27 Departments.Results: The ratio of endocrinologists-population was 1.4, much lower than in the other European countries (varies between 2 to 4), resulting in alarming shortages of services in some areas of Portugal and in worse quality indicators.Discussion: These data suggest that actions should be taken to increase the number of endocrinologists and departments in the country.Conclusion: In recent years, the number of residents has significantly increased, which will make it possible to correct this situation.

Workforce Responses to the Creeping Privatization of the UK National Health Service

2007 ◽  
Vol 71 (1) ◽  
pp. 133-153 ◽  
Author(s):  
Rebecca Kolins Givan ◽  
Stephen Bach
Keyword(s):  
National Health Service ◽  
Health Service ◽  
National Health ◽  
Health Sector ◽  
Support Staff ◽  
Public Hospitals ◽  
Family Doctors ◽  
Professional Employees ◽  
Uk National Health Service ◽  
The Uk

AbstractWhen the British National Health Service was founded in 1948, professional employees and support staff, with the exception of family doctors, worked directly for the state. Since the 1980s, private employment in the National Health Service (NHS) has steadily grown. Beginning with the outsourcing of support services, the number of privately-employed workers in the National Health Service has gradually increased. This paper argues that marketization in the health sector has increased dramatically under the New Labour government. As policymakers have moved from ideological to pragmatic justifications for marketization, union opposition has similarly become more pragmatic and less ideological. With unions unable to stop these reforms, they have turned to the practical concerns of their members in partially-privatized workplaces under complex employment arrangements. This article shows that while ideologically opposing marketization, unions and employees have been forced into a more pragmatic position. Research at two privately-funded public hospitals shows that unions in the workplace have used their resources to protect their members, as thwarting the involvement of the private sector is nearly impossible.

scholarly journals The COVID-19 pandemic from an acute psychiatric perspective: a London psychiatric intensive care unit experience

2020 ◽  
pp. 1-4 ◽  
Author(s):  
Luke Skelton ◽  
Ria Pugh ◽  
Bethan Harries ◽  
Lucy Blake ◽  
Margaret Butler ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
National Health Service ◽  
Health Service ◽  
National Health ◽  
Psychiatric Services ◽  
Extreme Pressure

Summary The COVID-19 pandemic has put the UK's National Health Service under extreme pressure, and acute psychiatric services have had to rapidly adapt to a new way of working. This editorial describes the experience of a London psychiatric intensive care unit (PICU) where all nine in-patients ultimately tested COVID-19 positive.

Organisational values of National Health Service trusts in England: semantic analysis and relation to performance indicators

BMJ Leader ◽  
2021 ◽  
pp. leader-2021-000512
Author(s):  
Amina Waheed ◽  
Edward Presswood ◽  
Gregory Scott
Keyword(s):  
National Health Service ◽  
Health Service ◽  
Sickness Absence ◽  
Language Processing ◽  
National Health ◽  
Semantic Analysis ◽  
Care Quality ◽  
Positive Effects ◽  
Universal Sentence ◽  
Organisational Values

BackgroundOrganisational values are widely assumed to have positive effects on performance and staff. National Health Service (NHS) trusts in England have accordingly chosen their own organisational values. However, there has been no survey of the values adopted, and there is little evidence that the choice of values per se has consequences for outcomes. We comprehensively described trusts’ organisational values, using natural language processing to identify common themes. We tested whether the choice of themes was associated with outcomes for patients and staff.MethodsWe collected data on trusts’ values (from their websites), performance (Summary Hospital-level Mortality Indicator (SHMI) statistics, Care Quality Commission (CQC) ratings), sickness absence rates (SAR) and staff opinions (NHS Staff Survey responses). We first characterised values based on lexical properties then progressed to semantic analysis, using Google’s Universal Sentence Encoder, to transform values to high-dimensional embeddings, and k-means clustering of embeddings to semantically cluster values into 12 common themes. We tested for associations between trusts’ use of these themes and outcomes.ResultsOrganisational values were obtained for 221 of 228 NHS trusts, with 985 values in total (480 unique). Semantic clustering identified themes including ‘care’, ‘value respect’ and ‘togetherness’. There was no significant association between themes and SHMI or CQC ratings. However, themes predicted trusts’ SAR (p=0.001, R2=0.159), with use of ‘care’, ‘value respect’, ‘aspirational’ and ‘people’ all significant predictors of increased sickness absence; themes also predicted staff opinions on ‘Equality, diversity and inclusion’ (p=0.011, R2=0.116), but with ‘supportive’ and ‘openness’ predicting more negative responses.ConclusionA trust’s adoption of individualised organisational values does not seem to make a positive difference to its patients or staff. These findings should give NHS managers pause for thought, challenging them to reconsider their reliance on value-defining initiatives, and to seek evidence that a focus on values has measurable benefits on outcomes.

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