Disaster-related communication preferences of homeless and nonhomeless VA patients

2018 ◽  
Vol 16 (1) ◽  
pp. 49 ◽  
Author(s):  
Alicia R. Gable, MPH ◽  
Claudia Der-Martirosian, PhD ◽  
Laura N. Pinnock, MSPH, PMP ◽  
Aram Dobalian, PhD, JD, MPH
Keyword(s):  
Natural Disasters ◽  
Medical Center ◽  
Healthcare Services ◽  
Veterans Affairs ◽  
Communication Strategy ◽  
Communication Preferences ◽  
Number Of Patients ◽  
Communication Modes ◽  
The Impact ◽  
E Mail

Objective: To identify the communication preferences of homeless (H) and nonhomeless (NH) Veterans Affairs (VA) patients for receiving information about the impact of natural disasters on VA healthcare services. Design: Probability-based sampling design stratified on age categories, urban/rural, coastal/noncoastal, and homelessness. Setting: Northeast United States.Participants: Eligible NH and H participants included those who lived in and had at least one healthcare visit to a VA medical center/clinic in the region in the previous 24 months. Homeless participants included those receiving VA homeless services or having ICD9-CM V60.0 (Lack of Housing). 2,264/6,088 NH and 383/2,000 H completed the survey.Intervention: Cross-sectional, mixed-mode survey administered August-November 2015.Main Outcome Measures: Helpfulness of ten communication modes for receiving information about the impact of natural disasters on VA healthcare services.Results: Despite sociodemographic and health status differences, the top five communication modes rated extremely/very helpful were the same for both groups: telephone (76 percent H; 81 percent NH), TV (63 percent H; 60 percent NH), text (62 percent H; 50 percent NH), e-mail (56 percent H; 58 percent NH), radio (54 percent H; 47 percent NH). Newspaper and online modes (VA/other Web sites, Twitter, Facebook, MyHealtheVet) were rated substantially lower. Conclusions: H and NH patients prefer similar communication modes for receiving updates about the impact of natural disasters on VA healthcare services. Findings suggest that a multimodal communication strategy that incorporates phone, TV, text, e-mail, and radio will help Veterans Affairs (VA) reach its diverse patient population during natural disasters. Dissemination of messages via online modes, while rated less helpful, may augment the number of patients reached.

scholarly journals 845. Impact of the COVID-19 Pandemic on Routine HIV Screening in an Emergency Department

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S513-S513
Author(s):  
Elizabeth A Aguilera ◽  
Gilhen Rodriguez ◽  
Gabriela P Del Bianco ◽  
Gloria Heresi ◽  
James Murphy ◽  
...  
Keyword(s):  
Emergency Department ◽  
Screening Program ◽  
Medical Center ◽  
Hiv Infections ◽  
Hiv Screening ◽  
Opt Out ◽  
Number Of Patients ◽  
Confirmatory Tests ◽  
Routine Hiv Screening ◽  
The Impact

Abstract Background The Emergency Department (ED) at Memorial Hermann Hospital (MHH) - Texas Medical Center (TMC), Houston, Texas has a long established screening program targeted at detection of HIV infections. The impact of the COVID-19 pandemic on this screening program is unknown. Methods The Routine HIV screening program includes opt-out testing of all adults 18 years and older with Glasgow score > 9. HIV 4th generation Ag/Ab screening, with reflex to Gennius confirmatory tests are used. Pre-pandemic (March 2019 to February 2020) to Pandemic period (March 2020 to February 2021) intervals were compared. Results 72,929 patients visited MHH_ED during the pre-pandemic period and 57,128 in the pandemic period, a 22% decline. The number of patients tested for HIV pre-pandemic was 9433 and 6718 pandemic, a 29% decline. When the pandemic year was parsed into first and last 6 months interval and compared to similar intervals in the year pre pandemic, 39% followed by 16% declines in HIV testing were found. In total, 354 patients were HIV positives, 209, (59%) in the pre-pandemic and 145 (41%) in the pandemic period.The reduction in new HIV infections found was directly proportional to the decline in patients visiting the MHH-ED where the percent of patients HIV positive was constant across intervals (2.21% vs 2.26%). Demographic and outcome characteristics were constant across the compared intervals. Conclusion The COVID -19 pandemic reduced detection of new HIV infections by screening in direct proportion to the reduction in MHH-ED patient visits. The impact of COVID-19 pandemic decreased with duration of the pandemic. Disclosures All Authors: No reported disclosures

Eliminating Critical Incident Tracking Network Patient Safety Events at a Veterans Affairs Institution Through Crew Resource Management Training

2016 ◽  
Vol 32 (5) ◽  
pp. 480-484 ◽  
Author(s):  
SreyRam Kuy ◽  
Ramon A. L. Romero
Keyword(s):  
Patient Safety ◽  
Resource Management ◽  
Adverse Events ◽  
Critical Incident ◽  
Medical Center ◽  
Crew Resource Management ◽  
Management Training ◽  
Veterans Affairs ◽  
Crew Resource Management Training ◽  
The Impact

The objective of this study was to determine whether rates of Critical Incident Tracking Network (CITN) patient safety adverse events change after implementation of crew resource management (CRM) training at a Veterans Affairs (VA) hospital. CRM training was conducted for all surgical staff at a VA hospital. Compliance with briefing and debriefing checklists was assessed for all operating room procedures. Tracking of adverse patient safety events utilizing the VA CITN events was performed. There was 100% adherence to performance of briefings and debriefings after initiation of CRM training. There were 3 CITN events in the year prior to implementation of CRM training; following CRM training, there have been zero CITN events. Following CRM training, CITN events were eliminated, and this has been sustained for 2.5 years. This is the first study to demonstrate the impact of CRM training on CITN events, specifically, in a VA medical center.

Quantification of the impact of multifaceted improvements in patient safety culture: A case study from academic medical center radiation oncology department.

2012 ◽  
Vol 30 (34_suppl) ◽  
pp. 205-205
Author(s):  
Bhishamjit S. Chera ◽  
Lukasz Maszur ◽  
Prithima Mosaly ◽  
Marianne Jackson ◽  
Kinely Taylor ◽  
...  
Keyword(s):  
Radiation Oncology ◽  
Peer Review Process ◽  
Medical Center ◽  
Academic Medical Center ◽  
Patient Safety Culture ◽  
Process Engineering ◽  
Patient Treatment ◽  
Task Load ◽  
Number Of Patients ◽  
The Impact

205 Background: We have systematically been incorporating several safety initiatives (based on process-engineering and Lean methodologies) into our academic radiation oncology clinic. We herein quantify the impact of these initiatives on prospectively collected, clinically meaningful metrics. Methods: The data from five quality improvement initiatives are presented. For each, data was collected prospectively: operational metrics recorded before and after implementation of the initiative were compared using descriptive statistics and unpaired student t-test. Each initiative focused on a specific safety/process concern in our clinic. Results: 1) Workload levels for nurses assisting with brachytherapy were too high (NASA task load index scores >55-60, suggesting, “overwork”). Changes in work flow and procedure room layout reduced workload scores to more acceptable limits (<55). 2) The rate of treatment therapists being interrupted was reduced from a mean of 4 (range 1-11) times per patient treatment to a mean < 1 (range 0-3, p<0.001) after implementing standards for electronic communication and placement of monitors informing patients and staff of the treatment machine status (e.g., delayed, on time). 3) The rates of replans by dosimetrists was reduced from 11% in 2010 to 6% in 2011 though a more systematic pre-treatment peer review process. 4) Standardizing nursing/resident functions reduced patient wait times by ≈ 45% (14 min). 5) Standardizing pre-simulation instructions from the physician within the EMR reduced the number of patients experiencing delays on the simulator (from approximatley >50% to <10%). Conclusions: Process engineering and Lean methodologies can be successfully applied in an academic radiation oncology department to yield measurable improvements in operations likely improving quality/safety.

A Multimodal Intervention to Reduce Urinary Catheter Use and Associated Infection at a Veterans Affairs Medical Center

2013 ◽  
Vol 34 (6) ◽  
pp. 631-633 ◽  
Author(s):  
Brady L. Miller ◽  
Sarah L. Krein ◽  
Karen E. Fowler ◽  
Karen Belanger ◽  
Debbie Zawol ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Urinary Catheter ◽  
Medical Center ◽  
Veterans Affairs ◽  
Quality Improvement Intervention ◽  
Tract Infections ◽  
The Impact ◽  
Improvement Intervention

We assessed the impact of a quality improvement intervention to reduce urinary catheter use and associated urinary tract infections (UTIs) at a single hospital. After implementation, UTIs were reduced by 39% (P = .04). Additionally, we observed a slight decrease in catheter use and the number of catheters without an appropriate indication.

scholarly journals Using Process Analysis to Assess the Impact of Medical Education on the Delivery of Pain Services

2012 ◽  
Vol 116 (4) ◽  
pp. 931-939 ◽  
Author(s):  
Kayode A. Williams ◽  
Chester G. Chambers ◽  
Maqbool Dada ◽  
Douglas Hough ◽  
Ravi Aron ◽  
...  
Keyword(s):  
Process Analysis ◽  
Medical Center ◽  
Academic Medical Center ◽  
Discrete Event ◽  
Economic Effects ◽  
Free Standing ◽  
Process Measures ◽  
Average Completion Time ◽  
Number Of Patients ◽  
The Impact

Background The medical, social, and economic effects of the teaching mission on delivery of care at an academic medical center (AMC) are not fully understood. When a free-standing private practice ambulatory clinic with no teaching mission was merged into an AMC, a natural experiment was created. The authors compared process measures across the two settings to observe the differences in system performance introduced by the added steps and resources of the AMC's teaching mission. Methods After creating process maps based on activity times realized in both settings, the authors developed discrete-event simulations of the two environments. The two settings were comparable in the levels of key resources, but the AMC process flow included three residents/fellows. Simulation enabled the authors to consider an identical schedule across the two settings. Results Under identical schedules, the average accumulated processing time per patient was higher in the AMC. However, the use of residents allowed simultaneous processing of multiple patients. Consequently, the AMC had higher throughput (3.5 vs. 2.7 patients per hour), higher room utilization (82.2% vs. 75.5%), reduced utilization of the attending physician (79.0% vs. 93.4%), and a shorter average waiting time (30.0 vs. 83.9 min). In addition, the average completion time for the final patient scheduled was 97.9 min less, and the average number of patients treated before incurring overtime was 37.9% greater. Conclusions Although the teaching mission of the AMC adds processing steps and costs, the use of trainees within the process serves to increase throughput while decreasing waiting times and the use of overtime.

scholarly journals Satisfaction With Healthcare: The Changes And Features Of Patients Making Aknowledgements For Doctors And Nurses Wiews

2016 ◽  
Vol 26 (5) ◽  
pp. 5-12
Author(s):  
Vinsas Janušonis
Keyword(s):  
Response Rate ◽  
Healthcare Services ◽  
University Hospital ◽  
Women Patients ◽  
Persons With Disabilities ◽  
Patients Satisfaction ◽  
Number Of Patients ◽  
The Right ◽  
The Impact ◽  
Doctors And Nurses

The aim of the study – to estimate patients, who gave thanks for medics – doctors and nurses opinion changes and singularity of right healthcare, satisfaction and fruition their expectations. Material and methods. From January 2004 to December 2015 a survey was performed in Klaipeda University Hospital (KUH). The study included 197755 patients who were undergoing treatment in KUH. Information was collected via questionnaires (response rate 81,4%). The patients who gave thanks for medics group was analyzed apart. The survey was analyzed and compared for the periods 2004-2006 and 2013-2015. Results and discussion. The most part of patients who gave thanks for medics was aged 50-69 (15, 8%), at work, women. The time of healthcare services, information for patients, good contact and communication between patients and medics, patients’ satisfaction influenced the number of thanks. The number of thanksgiving have not direct correlation with healthcare quality. Conclusions. Patients thanksgiving has confirmed the KUH provided healthcare for the majority of patients are appropriate to meet their expectations and they are satisfied with it. Comparison of both analyzed periods has shown that over 10 years fell acknowledgments for medics. Age, gender and social status had the impact on the number of acknowledgments - more thanksgiving was from women, patients 50-59 year age, retired and persons with disabilities. The right cooperation between medics and patients, provision of healthcare information to patients increased the number of thanksgiving. The number of patients who satisfied with healthcare results and meet their expectations directly correlated with number of patients who gave thanks for medics.

scholarly journals TO SEE THE IMPACT OF LOCKDOWN IN COVID19 PANDEMIC ON TUBERCULAR PATIENTS IN A TERTIARY CARE CENTRE OF HILLY AREA.

2020 ◽  
pp. 33-34
Author(s):  
Subhash Chander ◽  
Ritin Sharma ◽  
Ankit Chaudhary ◽  
Rakesh Chauhan
Keyword(s):  
Health Centre ◽  
Tertiary Care ◽  
Healthcare Services ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Tuberculosis Patients ◽  
Hilly Area ◽  
Number Of Patients ◽  
Group B ◽  
The Impact

Aim: To see the impact of lockdown in Covid19 Pandemic on Tubercular patients in a Tertiary care Centre of hilly area. Material and Methods: The study was conducted among adult patients in a tertiary health centre in a rural area. Study was conducted through lockdown period, comparing it with corresponding period in 2019. Tuberculosis patients or suspects were categorized in two groups. Group A was designated for participants in the year 2020 during lockdown period. Group B was data taken from time period similar to lockdown period in the year 2019. Data from two groups was compared. Observations: There was a 44.1% decline in number of male patients, whose sputum was examined by microscopy for tuberculosis. In case of female patients, decline was 68.6%. This decrease was present in all phases, more in 1st phase, 69.1%. During lockdown period number of patients presenting to medicine department were 45% compared to previous year ( 5129 vs 11280), sputum positive diagnosed during lockdown and similar period in 2019 were (84.4%) 27 vs 32 ( p 0.016). OPD declined by 54.5% during lockdown, however diagnosed tubercular cases by CBNAAT declined by 44.4%. Conclusion: COVID 19 pandemic greatly affected the routine healthcare services. Lockdown period saw a decline in number of patients presenting to outdoor as well as indoor patients. There was a decline in number of tuberculosis suspects as well as number of diagnosed tuberculosis patients. However decline in tuberculosis patients was less as compared to overall patients.

scholarly journals Improving the continuum of care monitoring in Brazilian HIV healthcare services: An implementation science approach

PLoS ONE ◽  
2021 ◽  
Vol 16 (5) ◽  
pp. e0250060
Author(s):  
Ana Paula Loch ◽  
Simone Queiroz Rocha ◽  
Mylva Fonsi ◽  
Joselita Maria de Magalhães Caraciolo ◽  
Artur Olhovetchi Kalichman ◽  
...  
Keyword(s):  
Implementation Science ◽  
Virologic Failure ◽  
Healthcare Services ◽  
Continuum Of Care ◽  
Public Healthcare ◽  
Treatment Gap ◽  
Positive Effects ◽  
Number Of Patients ◽  
The Impact ◽  
The Continuum

Objective To evaluate the impact of an intervention improving the continuum of care monitoring (CCM) within HIV public healthcare services in São Paulo, Brazil, and implementing a clinical monitoring system. This system identified three patient groups prioritized for additional care engagement: (1) individuals diagnosed with HIV, but not receiving treatment (the treatment gap group); (2) individuals receiving treatment for >6 months with a detectable viral load (the virologic failure group); and (3) patients lost to follow-up (LTFU). Methods The implementation strategies included three training sessions, covering system logistics, case discussions, and development of maintenance goals. These strategies were conducted within 30 HIV public healthcare services (May 2019 to April 2020). After each training session, professionals shared their experiences with CCM at regional meetings. Before and after the intervention, providers were invited to answer 23 items from the normalization process theory questionnaire (online) to understand contextual factors. The mean item scores were compared using the Mann–Whitney U test. The RE-AIM implementation science framework (evaluating reach, effectiveness, adoption, implementation, and maintenance) was used to evaluate the integration of the CCM. Results In the study, 47 (19.3%) of 243 patients with a treatment gap initiated treatment, 456 (49.1%) of 928 patients with virologic failure achieved suppression, and 700 of 1552 (45.1%) LTFU patients restarted treatment. Strategies for the search and reengagement of patients were developed and shared. Providers recognized the positive effects of CCM on their work and how it modified existing activities (3.7 vs. 4.4, p<0.0001, and 3.9 vs. 4.1, p<0.05); 27 (90%) centers developed plans to sustain routine CCM. Conclusion Implementing CCM helped identify patients requiring more intensive attention. This intervention led to changes in providers’ perceptions of CCM and care and management processes, which increased the number of patients engaged across the care continuum and improved outcomes.

scholarly journals Effect of Immersive Virtual Reality on Pain and Anxiety at a Veterans Affairs Health Care Facility

2021 ◽  
Vol 2 ◽  
Author(s):  
Caitlin R. Rawlins ◽  
Zachary Veigulis ◽  
Catherine Hebert ◽  
Catherine Curtin ◽  
Thomas F. Osborne
Keyword(s):  
Health Care ◽  
Virtual Reality ◽  
Rating Scale ◽  
Medical Center ◽  
Care Facility ◽  
Veterans Affairs ◽  
Primary Objective ◽  
Head Mounted Display ◽  
Anxiety Levels ◽  
The Impact

Objectives: The primary objective of this evaluation is to determine the impact of virtual reality (VR) distraction on acute and chronic pain in Veterans within the Veterans Affairs Health Care System (VA). A secondary objective is to determine the impact of VR on the experience of stress and anxiety in Veterans utilizing VR for the indication of pain. A third objective is to develop an understanding of the Veteran experience of using VR in a healthcare setting.Methods: This prospective, pretest-posttest mixed methods assessment was performed at a VA medical center from August 30, 2019 to November 23, 2020. VR experiences lasted between 10 and 30 min utilizing an immersive head-mounted display with multiple, autonomously chosen virtual environments. Qualitative data was collected concurrently to provide context to quantitative measures which included pain scores and stress/anxiety levels. Data from 79 participants was included in this analysis. Data included pre- and post-VR session Defense and Veterans Pain Rating Scale and stress/anxiety levels.Results: Results for the cohort demonstrated a statistically significant decrease in pain intensity (p &lt;0 .001) with an average 12% decrease in pain levels and an 92% reduction in anxiety for those in concurrent pain.Conclusion: VR as a non-pharmacological adjunct or alternative modality, appears to be a viable option for improving pain management and reducing anxiety in Veteran populations across various age ranges, and levels of acuity and chronicity. VR was found to be an effective distraction from pain, a pleasurable experience for the majority, and opened the door to other non-pharmacological modalities in a Veteran population.

Komunikasi Kebencanaan: Suatu Strategi Dalam Membangun Masyarakat Sadar Bencana Pada BPBD Kota Mataram

2020 ◽  
Vol 6 (2) ◽  
pp. 143-150
Author(s):  
Baiq Vira Safitri ◽  
Shinta Desiyana Fajarica ◽  
Yulanda Trisula ◽  
Novita Maulida ◽  
Gemuh Surya Wahyudi
Keyword(s):  
Natural Disasters ◽  
Disaster Management ◽  
Management Strategies ◽  
Communication Strategy ◽  
Environmental Damage ◽  
Disaster Reporting ◽  
The Government ◽  
The Moment ◽  
The Impact ◽  
Selection Of

A disaster is an event that threatens and disrupts people's lives and livelihoods which are caused, both by natural and / or non-natural factors as well as human factors, resulting in human casualties, environmental damage, property loss and psychological impacts. According to Law Number 24 of 2007 concerning Disaster Management, disasters are classified into three parts; natural disasters, non-natural disasters and social disasters. The impact of disasters, especially natural disasters, varies from the moment of occurrence to post-disaster. Referring to the series of earthquake events in Lombok on 29 July 2018 (M6.4), 5 August 2018 (M7.0) and 19 August 2018 (M6.9), until 1 September 2018 has claimed 564 victims and suffered losses with the total rough count reached IDR 12.15 trillion. The impact of the earthquake is a lesson for the government and related agencies, in this case the Mataram City BPBD to better prepare disaster management strategies in a mature and planned manner. This study aims to determine the disaster communication strategy of the Mataram City BPBD in building a disaster-aware Mataram community using qualitative methods. The results of the research also show, among others: (1) Determination of communicators / community leaders as a credible source; (2) Selection of messages that are easy to understand; (3) Selection of disaster reporting media; (4) Mapping communication barriers in building disaster-aware communities

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