The United Kingdom and the Netherlands maternity care responses to COVID-19: a comparative study

Background: The national health care response to coronavirus (COVID-19) has varied between countries. The United Kingdom (UK) and the Netherlands (NL) have comparable maternity and neonatal care systems, and experienced similar numbers of COVID-19 infections, but had different organisational responses to the pandemic. Understanding why and how similarities and differences occurred in these two contexts could inform optimal care in normal circumstances, and during future crises. Aim: To compare the UK and Dutch COVID-19 maternity and neonatal care responses in three key domains: choice of birthplace, companionship, and families in vulnerable situations. Method: A multi-method study, including documentary analysis of national organisation policy and guidance on COVID-19, and interviews with national and regional stakeholders. Findings: Both countries had an infection control focus, with less emphasis on the impact of restrictions. Differences included care providers’ fear of contracting COVID-19; the extent to which personalised care was embedded in the care system before the pandemic; and how far multidisciplinary collaboration and service-user involvement were prioritised. Conclusion: We recommend that countries should 1) make a systematic plan for crisis decision-making before a serious event occurs, and that this must include authentic service-user involvement, multidisciplinary collaboration, and protection of staff wellbeing 2) integrate women’s and families’ values into the maternity and neonatal care system, ensuring equitable inclusion of the most vulnerable and 3) strengthen community provision to ensure system wide resilience to future shocks from pandemics, or other unexpected large-scale events.

Absence of menstruation in female athletes: why they do not seek help

Background It is known that amenorrhea is highly prevalent among female athletes. However, a large percentage of them do not seek help if this complaint occurs. We performed this study to gain more insight into the reasons why female athletes do not seek help when experiencing amenorrhea and how care for these women could be improved. Method Qualitative focus group research. Female athletes were approached to take part in a focus group. They were asked about the main reasons for not reporting amenorrhea and how care for amenorrhea, in their opinion, would ideally be organised. The women were asked to make a list of their top five reasons for both subjects and discuss this among their peers. Results According to the participants, the five main reasons for not reporting the amenorrhea were: (1) normalizing of the subject, (2) the absence of menstruation is not perceived as a problem by the athletes themselves, (3) experienced shame and taboo, (4) prioritisation of sports performance, and (5) denial. Factors to improve care around menstrual cycle problems in female athletes were: (1) informing athletes, coaches, trainers and mentors, (2) informing doctors, (3) conducting more research on long-term consequences, (4) breaking the taboo on menstrual problems, and (5) having a multidisciplinary collaboration between different specialisms. Conclusion By informing athletes, coaches, trainers, and mentors about menstrual cycle problems in athletes, more awareness among those groups can be created. According to the athletes, more research is needed on the long-term consequences of amenorrhea in sports, to enable them to make a better assessment of their possible future health risks. Women experience a taboo on discussing menstrual problems; role models discussing the problem may help in decreasing the taboo. A multidisciplinary collaboration of health care providers may improve care around female athletes with menstrual problems.

Kolaborasi Multidisiplin Pelaksanaan Discharge Planning

Discharge planning adalah suatu proses multidisplin yang melibatkan Profesioanal Pemberi Asuhan (PPA) dan Manajer Pelayanan Pasien (MPP) yang bertujuan untuk mengurangi lama tinggal atau perawatan di rumah sakit, mencegah terjadinya readmisi dan meningkatkan kordinasi layanan setelah keluar dari rumah sakit. Penelitian ini bertujuan untuk mengevaluasi kolaborasi multidisiplin pelaksanaan discharge planning di RSUD Haji Makassar dengan menggunakan pendekatan observasional pre-post implementasi pendokumentasian discharge planning dan metode wawancara dalam bentuk focus group discussion (FGD) terhadap kepala bidang keperawatan, kepala ruangan, ketua tim, perawat pelaksana dan tim pokja. Instrumen yang digunakan adalah instrumen wawancara dan instrumen discharge planning terintegrasi. Hasil yang didapatkan yaitu pendokumentasian discharge planning di RSUD Haji Makassar belum optimal sehingga dilakukan beberapa program kegiatan yaitu studi literature, penyegaran tim, pelatihan, pembuatan panduan, form dan SOP discharge planning, uji coba form dan evaluasi. Setelah implementasi didapatkan peningkatan pendokumentasian discharge planning menjadi 77.7%, Selain itu, discharge planning juga dilakukan pada saat pasien masuk di ruang rawat inap hingga pasien sebelum pulang. Oleh karena itu, pada penelitian selanjutnya dibutuhkan penelitian terkait pendokumenatsian discharge planning secara multidisiplin, serta perlunya monitoring dan evaluasi terhadap pelaksanaan discharge planning. Multidisciplinary Collaboration on Discharge Planning Implementation ABSTRACTDischarge planning is a multidisciplinary process that involves the Professional Care Provider (PPA) and the Patient Services Manager (MPP) aims to reduce the length of stay or treatment in the hospital, prevent readmissions and improve service coordination after discharge from the hospital. This research to evaluate multidisciplinary collaboration implementation of discharge planning in Haji Hospital Makassar using an observational approach pre-post implementation of discharge planning documentation and interview method in focus group discussions (FGD) of head nurse, chief nurse, team leader, nurse associate, and team. The instrument used was an interview instrument and an integrated discharge planning instrument. The results obtained were documentation of discharge planning in Haji Hospital Makassar was not optimal so that several program activities were literature study, team refreshment, training, making guidelines, form and SOP discharge planning, trial form, and evaluation. After implementation, there was an increase in the documentation of discharge planning to 77.7%. In addition, discharge planning was also carried out when the patient entered the inpatient room to the patient before leaving. Therefore, further research is needed in order to discharge planning documentation by a multidisciplinary team, monitoring, and evaluation of the discharge planning implementation. Keyword: Multidisciplinary Collaboration; Discharge Planning

Managing reproductive problems in women with epilepsy of childbearing age

Girls and women constitute nearly 50% of all epilepsy cases. Apart from the disease symptoms, epilepsy and antiseizure medications (ASMs) may also affect the reproductive function, pregnancy and even the health of their offspring. Therefore, it is very important to identify and summarize the problems and risks for women with epilepsy (WWE) of childbearing age, and offer internationally recognized methods through multidisciplinary collaboration. In this review, we summarize the reproduction-related problems with WWE and propose multidisciplinary management by epileptologists, gynecologists and obstetricians, as well as other experts, from preconception to delivery. Large, multicenter registries are needed to advance our knowledge on new ASMs and their effects on WWE and their offspring.

Collaboration in the time of COVID: a scientometric analysis of multidisciplinary SARS-CoV-2 research

The novel coronavirus SARS-CoV-2 and the COVID-19 illness it causes have inspired unprecedented levels of multidisciplinary research in an effort to address a generational public health challenge. In this work we conduct a scientometric analysis of COVID-19 research, paying particular attention to the nature of collaboration that this pandemic has fostered among different disciplines. Increased multidisciplinary collaboration has been shown to produce greater scientific impact, albeit with higher co-ordination costs. As such, we consider a collection of over 166,000 COVID-19-related articles to assess the scale and diversity of collaboration in COVID-19 research, which we compare to non-COVID-19 controls before and during the pandemic. We show that COVID-19 research teams are not only significantly smaller than their non-COVID-19 counterparts, but they are also more diverse. Furthermore, we find that COVID-19 research has increased the multidisciplinarity of authors across most scientific fields of study, indicating that COVID-19 has helped to remove some of the barriers that usually exist between disparate disciplines. Finally, we highlight a number of interesting areas of multidisciplinary research during COVID-19, and propose methodologies for visualising the nature of multidisciplinary collaboration, which may have application beyond this pandemic.

Will Multidisciplinary Collaboration Reduce the Disability Rate of Diabetic Foot (2009–2019)?—A Study Based on the Perspective of Organizational Reform

Objectives: Discuss the experience and practice of multidisciplinary cooperation of diabetic foot in China and analyze its impact on the quality of care.Methods: This study observed the medical procedure by interviewing 12 key personnel in-depth. We extracted data from medical records and assessed the effect of MDT in three dimensions: quality, efficiency, and cost, to eventually achieve a final conclusion.Results: The studied reform includes the following three aspects: the adjustment of hospital buildings layout and disciplines, one-stop outpatient, and one-stop inpatient service. After the multidisciplinary collaboration, the rate of above-knee amputation is reduced by 3.63%, the disability score per 100 diabetic foot patients decreases by 6.12, the average length of stay decreases significantly, and the cost of hospitalization shows an increasing trend.Conclusions: Multidisciplinary collaboration is performed based on spatial layout adjustment and clinical pathway optimization, which provide more comprehensive and integrated care than a general medical team or a single specialist, thereby reducing the rate of disability, shortening the length of hospitalization. Besides, the new measurable indicator called disability score per 100 diabetic foot patients has been verified to evaluate the living ability of patients after surgery. This paper provides a reference for organizational reform of multidisciplinary diseases to support treatment and management of other multiorgan diseases.