Patient Perceptions of Drive-through Medical Treatment Facilities During the COVID-19 Pandemic

Introduction: The cumulative burden of coronavirus disease 2019 (COVID-19) on the United States’ healthcare system is substantial. To help mitigate this burden, novel solutions including telehealth and dedicated screening facilities have been used. However, there is limited data on the efficacy of such models and none assessing patient comfort levels with these changes in healthcare delivery. The aim of our study was to evaluate patients’ perceptions of a drive-through medical treatment system in the setting of the COVID-19 pandemic. Method: Patients presenting to a drive-through COVID-19 medical treatment facility were surveyed about their experience following their visit. An anonymous questionnaire consisting of five questions, using a five-point Likert scale was distributed via electronic tablet. Results: We obtained 827 responses over two months. Three quarters of respondents believed care received was similar to that in a traditional emergency department (ED). Overall positive impression of the drive-through was 86.6%, and 95% believed that it was more convenient. Conclusion: Overall, the drive-through medical system was perceived as more convenient than the ED and was viewed as a positive experience. While representing a dramatic change in the delivery model of medical care, if such systems can provide comparable levels of care, they may be a viable option for sustained and surge healthcare delivery.

Download Full-text

Retrospective Assessment of the Efficacy of Modified Progressive Tinnitus Management Skills Education in a Military Medical Treatment Facility

Military Medicine ◽

10.1093/milmed/usz024 ◽

2019 ◽

Vol 184 (9-10) ◽

pp. e468-e473 ◽

Cited By ~ 1

Author(s):

LaGuinn P Sherlock ◽

Candice E Ortiz ◽

Georgina P Blasco ◽

Daniel I Brooks

Keyword(s):

Medical Treatment ◽

Outcome Measures ◽

Primary Outcome ◽

Secondary Outcome ◽

Published Data ◽

Treatment Facility ◽

Coping Ability ◽

Medical Treatment Facility ◽

Treatment Facilities ◽

Skills Education

Abstract Introduction The number-one service-connected disability is tinnitus. Tinnitus currently has no cure, but the functional impact of tinnitus has been shown to be mitigated by Progressive Tinnitus Management (PTM), a multi-level management approach. The duration of PTM Level 3 skills education (PTM-SE) and the inclusion of mental health providers have been identified as barriers to implementation of PTM-SE in Department of Defense (DOD) medical treatment facilities. The goal of this study was to determine if a version of PTM-SE modified for use in DOD medical treatment facilities resulted in positive changes in tinnitus-related outcomes. Materials and Methods A retrospective study was conducted by examining the medical records of patients who attended modified PTM-SE appointments. The study was approved by the Walter Reed National Military Medical Center Institutional Review Board. The study sample included 130 patients who completed modified PTM-SE between January 2015 and June 2016. Primary outcome measures were tinnitus awareness and tinnitus annoyance; secondary outcome measures were effect on life and self-perceived coping ability. Outcome measures were analyzed with nonparametric statistics and logistic regression. Results Modified PTM-SE resulted in clinically significant improvements in the primary outcome measures (awareness, p < 0.0001; annoyance, p < 0.0001). The proportion of patients who indicated an improvement in coping with tinnitus was similar to other published data with similar modifications to PTM-SE. Conclusions The evidence supports the assumption that PTM is a flexible program of tinnitus management that even when modified to be suitable for use in a DOD medical treatment facility provides meaningful reductions in tinnitus awareness and annoyance and improves tinnitus coping ability among military beneficiaries. These findings should encourage audiologists to modify PTM to work within their military medical treatment facility.

Download Full-text

Partners in Care

Healthcare Management Forum ◽

10.1016/s0840-4704(10)61395-6 ◽

1988 ◽

Vol 1 (2) ◽

pp. 8-13

Author(s):

Marjorie Beyers

Keyword(s):

United States ◽

Acute Care ◽

Healthcare Delivery ◽

The United States ◽

Business Planning ◽

Healthcare Industry ◽

New Methods ◽

The Future ◽

United States Healthcare

In the United States, healthcare industry changes are affecting the manner in which hospitals and physicians are paid, the number of acute care beds is dwindling, and hospitals are becoming more efficient using the same or slightly reduced resources. These factors are leading to new methods in healthcare delivery, including the formation of partnerships among physicians, nurses, trustees and administrators. Leaders must not only have certain characteristics, but learn methods of business planning and work with cost centres for budgeting. Partnerships between key disciplines are becoming the bridge to the future.

Download Full-text

Balancing Patient Care and Force Protection at Military Medical Treatment Facilities

Military Medicine ◽

10.1093/milmed/usz204 ◽

2020 ◽

Vol 185 (Supplement_1) ◽

pp. 562-564

Author(s):

Sean Nardi ◽

Brian Ferguson ◽

Sean Peck ◽

Elliot Ross ◽

Benjamin Walrath

Keyword(s):

Medical Treatment ◽

Medical Condition ◽

Security Protocols ◽

Unauthorized Access ◽

Access Points ◽

Medical Treatment Facility ◽

Emergency Medical ◽

Hospital Access ◽

Treatment Facilities ◽

Sensitive Conditions

ABSTRACT Objectives This study aimed to identify delays of care due to base access security protocols at a stateside military medical treatment facility (MTF) for patients with a time-sensitive medical condition who are seeking emergency medical care at the MTF. Methods We retrospectively analyzed emergency medical services (EMS) run reports from January 1, 2017 to November 12, 2017 to hospital access points to assess patients who were initially denied access to the MTF. Time from EMS activation until patient delivery at the emergency department, number of time-sensitive complaints, number of time-sensitive conditions, and number of unauthorized access attempts are reported. Results During the 11-month period of review, 42 delays of care related to EMS activation by the sentry at hospital access points were identified. Of the 42, 14 were associated with a time-sensitive complaint, 2 with time-sensitive conditions, and none were unauthorized access attempts. Conclusion We identify the potential for patient harm due to delays in care resulting from the security protocols at our MTF. A review of force protection requirements with consideration for their impact on patient safety, especially in cases of time-sensitive conditions, has been conducted.

Download Full-text

Deployed ophthalmic workload in support of US and NATO operations in Afghanistan

BMJ Military Health ◽

10.1136/bmjmilitary-2019-001379 ◽

2020 ◽

pp. bmjmilitary-2019-001379 ◽

Cited By ~ 2

Author(s):

Richard J Blanch ◽

M T Kerber ◽

W G Gensheimer

Keyword(s):

Medical Treatment ◽

Active Duty ◽

Treatment Facility ◽

Aeromedical Evacuation ◽

Medical Treatment Facility ◽

Us Military ◽

Active Duty Military ◽

Ophthalmic Pathology ◽

Treatment Facilities ◽

Ophthalmic Disease

PurposeThe extent and types of ophthalmic disease and non-battle injury (DNBI) seen by expeditionary ophthalmologists at deployed military medical treatment facilities have not previously been reported. We aim to characterise the extent and type of ophthalmic pathology including DNBI at a US military medical treatment facility in Afghanistan.MethodsWe conducted a retrospective non-interventional cohort study of all patients seen by ophthalmologists at Craig Joint Theater Hospital at Bagram Airfield (BAF), Afghanistan, between 1 October 2018 and 31 August 2019.ResultsThere were 281 patients seen in 540 separate encounters, of which 146 patients seen were active duty military stationed at BAF with DNBI, of a population at risk of 6000 personnel. Diagnoses managed included open and closed globe injury, bacterial and herpetic keratitis and retinal detachment, with the most common being dry eye, corneal abrasion/foreign body, blepharitis, chalazion and uveitis. Thirteen patients (5%) required aeromedical evacuation out of theatre and 39 patients were aeromedically transferred within theatre for assessment. Expert consensus estimated that 89 patients (36%) would be likely to require aeromedical evacuation out of theatre without ophthalmic input.ConclusionsThe rate of ophthalmic DNBI among deployed US, UK and coalition forces at BAF was 2.65% per year, of whom 97% were returned to duty (95% of all patients). We estimate that evacuation and loss to unit would increase from 5% to 36% without an ophthalmologist present. The low number of within-theatre aeromedical transfers suggests that the local presence of an ophthalmologist at a patient’s deployed medical treatment facility affects access to deployed ophthalmic care.

Download Full-text

Ideal body position for epinephrine autoinjector administration

Allergy and Asthma Proceedings ◽

10.2500/aap.2020.42.200108) ◽

2020 ◽

Author(s):

Qing Wang ◽

Luke Pittman ◽

Andrew Healey ◽

James Chang ◽

T. Ted Song

Keyword(s):

Body Position ◽

Vastus Lateralis ◽

The United States ◽

Thigh Muscle ◽

First Line ◽

Medical Treatment Facility ◽

First Line Therapy ◽

Epinephrine Autoinjector ◽

Ideal Body ◽

The Ideal

Background: Epinephrine is the first-line therapy for patients with anaphylaxis, and intramuscular (IM) delivery is shownto be superior to subcutaneous (SC) delivery. There currently is no consensus on the ideal body position for epinephrine autoinjector (EAI) administration.Objective: We designed this study to investigate whether SC tissue depth (SCTD) is affected by body position (e.g., standing, sitting, supine), which can potentially impact delivery of EAI into the IM space.Methods: Volunteer adults (ages >/= 18 years) from a military medical treatment facility in the United States were recruitedto participate in this study. SCTD of the vastus lateralis was measured via ultrasound at standing, sitting, and supine bodypositions. Subjects’ age, sex, and body mass index (BMI) were collected. Statistical analysis was performed to compare averageSCTD between body positions, sex, and BMI.Results: An analysis of variance of 51 participants (33 men and 18 women) did not reveal statistically significant differencein SCTD among standing, sitting, and supine body positions. It did show a significantly greater SCTD in women than in men (2.72 +/- 1.36 cm versus 1.10 +/- 0.38 cm; p < 0.001). There was no significant association observed between BMI and SCTD in this study.Conclusion: Body position did not seem to significantly change the distance between skin and thigh muscle in adults. Thiswould suggest that there might not be an ideal body position for EAI administration. Therefore, in case of anaphylaxis, promptadministration of epinephrine is recommended at any position.

Download Full-text