scholarly journals Relocation and transfer of patients to a new hospital: Practical lessons

2021 ◽  
Vol 10 (1) ◽  
pp. 23
Author(s):  
Ged Williams ◽  
Nawal A. Awad ◽  
Devin Roloff ◽  
Craig E. Daniels

Objective: We describe the practical aspects of planning for and executing the safe movement of patients and care teams from an existing tertiary hospital (Mafraq Hospital) to a new hospital (Sheikh Shakhbout Medical City) in Abu Dhabi, United Arab Emirates.Methods: Field notes and measures taken during the planning and execution of this event were prospectively collated by the authors to inform the final manuscript.Results: A central command structure similar to that used for major disaster management helped to guide the move of all inpatients, staff and support services from one hospital to the other. Five patient tracks (clinical teams) were established to move patients to the new facility concurrently along set and separate routes. Five additional support tracks were established to provide logistical support for the movement of essential non-patient resources. A total of 142 acutely ill general care and critically ill hospital patients were moved during a five-hour period with zero patient harm events.Conclusions: The tools, processes used, and lessons learned in this exercise are shared in the hope that others who are required to move hospitals can learn from and use our experience.

2020 ◽  
Vol 06 (03) ◽  
pp. e167-e170
Author(s):  
Hemanga K. Bhattacharjee ◽  
Shafneed Chaliyadan ◽  
Eshan Verma ◽  
Keerthi Kumaran ◽  
Priyank Bhargava ◽  
...  

Abstract Introduction The ongoing coronavirus disease-2019 (COVID-19) pandemic has disrupted health services throughout the world. It has brought in several new challenges to deal with surgical emergencies. Herein, we report two suspected cases of COVID-19 that were operated during this “lockdown” period and highlight the protocols we followed and lessons we learned from this situation. Result Two patients from “red zones” for COVID-19 pandemic presented with acute abdomen, one a 64-year male, who presented with perforation peritonitis and another, a 57-year male with acute intestinal obstruction due to sigmoid volvulus. They also had associated COVID-19 symptoms. COVID-19 test could not be done at the time of their presentation to the hospital. Patients underwent emergency exploratory laparotomy assuming them to be positive for the infection. Surgical team was donned with full coverall personal protective equipment. Sudden and uncontrolled egression intraperitoneal free gas was avoided, Echelon flex 60 staplers were used to resect the volvulus without allowing the gas from the volvulus to escape; mesocolon was divided using vascular reload of the stapler, no electrosurgical devices were used to avoid the aerosolization of viral particles. Colostomy was done in both the patients. Both the patients turned out to be negative for COVID-19 subsequently and discharged from hospital in stable condition. Conclusion Surgeons need to adapt to safely execute emergency surgical procedures during this period of COVID-19 pandemic. Preparedness is of paramount importance. Full precautionary measures should be taken when dealing with any suspected case.


Author(s):  
Darlington E Obaseki ◽  
Iriagbonse I Osaigbovo ◽  
Esohe O Ogboghodo ◽  
Omokhoa Adeleye ◽  
Obehi A Akoria ◽  
...  

Abstract Africa was the last continent to be affected by the COVID-19 pandemic. Much of the discourse on Africa's response captured in scientific journals revolves around nations, public health agencies and organizations, but little is documented about how individual healthcare facilities have fared. This article reports the challenges faced in a tertiary hospital in Nigeria, including space constraints, diagnostic challenges, shortages in personal protective equipment and health worker infections. The opportunities and strengths that aided the response are also highlighted. The lessons learned will be useful to similar facilities. More information about health facility response at various levels is needed to comprehensively assess Africa's response to the pandemic.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Nam-Eun Kim ◽  
Sanghun Lee ◽  
Bo Yeon Kim ◽  
Ae Gi Hwang ◽  
Ji Hyeon Shin ◽  
...  

AbstractMedical costs have recently increased in South Korea due to the rising rate of asthma. Primary clinics serve an important role in asthma management, as they are the first stop for patients presenting with symptoms. The Health Insurance Review and Assessment Service (HIRA) in South Korea has assessed asthma-management quality since 2013, but studies are lacking on whether these assessments have been performed properly and contribute toward reducing asthma exacerbations. Therefore, we investigated whether the HIRA’s quality assessments have decreased asthma exacerbations using national health insurance claims data from 2013 to 2017 of 83,375 primary-clinic and 15,931 tertiary-hospital patients with asthma. These patients were classified into four groups based on disease severity according to the monthly prescribed amount of asthma medication using K-means clustering. The associations between HIRA assessments and asthma exacerbation were analyzed using a generalized estimating equation. Our results showed that exacerbation odds gradually decreased as the HIRA assessments progressed, especially in the mild-severity group, and that exacerbation risk among patients with asthma decreased in the order of assessment grades: “Unsatisfactory,” “Satisfactory,” and “Tertiary.” Therefore, we may conclude that asthma exacerbations may decrease with high quality asthma management; appropriate quality assessment could be helpful in reducing asthma exacerbations.


2020 ◽  
Author(s):  
Caroline Wanjiru

Abstract World capture fisheries are declining while demand for fish is increasing due to population increase and an upward trend in diet preference where fish is preferred over white meat. It is hoped that aquaculture will help meet this deficit. In Kenya, coastal aquaculture remains under-developed even though over 3900 hectares of land have been designated as suitable for aquaculture. This case study is based on a study where Indian shrimp (Penaeus indicus) were cultured for 106 days, in hapas, inside fertilized ponds at Majaoni in Mtwapa creek, Mombasa district, Kenya. The manures used for pond fertilization were chicken, urea and cow dung. No manure was added in the control treatment. Physical, chemical and biological water parameters were taken weekly, fortnightly and monthly, respectively. Growth performance of the shrimp in terms of weight (g) and length (mm) was monitored fortnightly. The mean growth rates ranged between 1.13 and 2.34% day-1 in the control and chicken manure treated ponds, respectively. The highest net yield (NFY Kg ha-1) and annual production (AP Kg ha-1 yr-1) achieved was 18.87 Kg ha-1 and 64 Kg ha-1 yr-1, respectively, in the cow dung-treated ponds. The data collected from this study formed part of the author's MSc thesis in Aquaculture at the University of Nairobi. A major part of the study was funded by Alcoa Foundation's Conservation and Sustainability Fellowship Program which supported the author as a Practitioner Fellow in 2008. Additional support was provided through the Western Indian Ocean Marine Science Association (WIOMSA) small grant programme.


2019 ◽  
Vol 34 (7) ◽  
pp. 432-438
Author(s):  
Kimberly C. McKeirnan ◽  
Karen Colorafi ◽  
Shannon G. Panther ◽  
Darryl Potyk ◽  
John McCarthy

OBJECTIVE: To describe an interdisciplinary academic detailing project implemented to address low pneumococcal immunization rates. SETTING: Two medical clinics and four community pharmacies in rural Washington state. PRACTICE DESCRIPTION: The two medical clinics and four community pharmacies were all located in two rural counties and serve geographically large rural areas. PRACTICE INNOVATION: Academic detailing is an evidence-based approach designed to change clinical practice and improve decision-making. Our team utilized the academic detailing model to provide educational outreach to local rural health care providers. The detailing team visited each clinic and pharmacy on a defined schedule and provided information to physicians, clinic administrators, nurses, pharmacists, pharmacy technicians, medical assistants, and clinic front-end staff. MAIN OUTCOME MEASUREMENTS: The project team maintained detailed field notes from each academic detailing the visit and met to debrief about each encounter. From the field notes, through the process of thematic analysis and analytic memoing, the project team produced a list of "lessons learned" that could be used to guide other interprofessional teams wishing to embark on an academic detailing project. RESULTS: We have identified four key "lessons learned": Interprofessional team members bring different strengths to the project; using same-discipline team members paved the way for success; involving students aids in educating future practitioners in interprofessional practice; and scheduling meetings in advance is important. CONCLUSION: We described an approach to enhanced academic detailing using interprofessional team delivery, bringing interprofessional practice into the real-world practice setting.


2013 ◽  
Vol 19 (3) ◽  
pp. 232
Author(s):  
Soo-Yong Shin ◽  
Yongman Lyu ◽  
Yongdon Shin ◽  
Hyo Joung Choi ◽  
Jihyun Park ◽  
...  

2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
Wanjala F. Nangole ◽  
Stanley Khainga ◽  
Joyce Aswani ◽  
Loise Kahoro ◽  
Adelaine Vilembwa

Introduction. Free flap surgery is a routine procedure in many developed countries with good surgical outcomes. In many developing countries, however, these services are not available. In this paper, we audit free flaps done in a resource constrained hospital in Kenya. Objective. This is a five-year audit of free flaps done in a tertiary hospital in Kenya, between 2009 and 2014. Materials and Methods. This was a prospective study of patients operated on with free flaps between 2009 and 2014. Results. A total of one hundred and thirty-two free flaps in one hundred and twenty patients were performed during the five-year duration. The age range was eight to seventy-two years with a mean of 47.2. All the flaps were done under loupe magnification. The overall flap success rate was eighty-nine percent. Conclusion. Despite the many limitations, free flaps in our setup were successful in the majority of patients operated on. Flap salvage was noted to be low due to infrequent flap monitoring as well as unavailability of theatre space. One therefore has to be meticulous during surgery to reduce any possibilities of reexploration.


2021 ◽  
pp. 152483992110285
Author(s):  
Taylor Newman ◽  
Jung Sun Lee

Produce prescription programs (PPPs) have grown in numbers in the past decade, empowering health care providers to promote health by issuing subsidies for produce to vulnerable patients. However, little research has been conducted on the facilitators that make it easier for PPPs to succeed or the barriers that programs face, which could provide guidance on how to improve future PPP design and implementation. The study sought to identify the facilitators and barriers affecting positive outcomes in Georgia PPPs called Fruit and Vegetable Prescription (FVRx) Programs. A process evaluation with a qualitative comparative case study approach was conducted. Fifteen FVRx providers, ranging from nutrition educators to farmers market managers, were interviewed in a focus group interview or on the phone between 2016 and 2017. Two nutrition education classes and an FVRx best practices meeting were observed, and program documents were collected. Interview transcripts, field notes from observations, and documents were then thematically analyzed. Four overall themes were determined regarding facilitators and barriers experienced by FVRx programs: (1) creating accessible programming may encourage FVRx participation, (2) provider dedication to the program is important, (3) participants’ challenging life circumstances can make participation difficult, and (4) the sustainability of the program is a concern. The findings of this study suggest helpful strategies and challenges for providers to consider when developing and implementing PPPs in Georgia and beyond. Research on the long-term program impact is needed, and policy options for sustainable, scaling up of PPPs should be explored.


2019 ◽  
Vol 74 (2) ◽  
pp. 261-267
Author(s):  
José L. A. Borges ◽  
Ivens A. O. De Souza ◽  
Michele C. V. Costa ◽  
Fabiana Ruotolo ◽  
Livia M. G. Barbosa ◽  
...  

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