Do callers to the NSW Sexual Health Infoline attend the services they are referred to?

BackgroundThe NSW Sexual Health Infoline (SHIL) is a free and confidential sexual health information and referral line. The ability of Australian sexual health helplines to facilitate successful referrals has not been studied. In the present study, we sought to determine whether callers were successful in accessing the publicly funded sexual health services (PFSHS) or general practitioners (GP) they were referred to. Methods: Callers to SHIL who were directly referred to a PFSHS or GP for HIV and/or sexually transmissible infection testing from 3 January to 31 March 2012 were offered a follow-up phone call 1 week later. Results: Of 474 eligible callers, 190 (40%) agreed to disclose a first name and contact details and to be contacted by a study nurse on an agreed-upon date. One hundred and twenty (63%) callers were successfully contacted 1 week later; of these, 85% had attended or had a future appointment booked for testing. Conclusions: We conclude that among the study sample that was successfully followed up, most callers to the SHIL had attended or booked appointments to the services they were referred to.

Challenges in organizing care networks for the elderly in two regions of Brazil

The global trend of ageing populations is present in Brazil. Brazilian society is going through an intensive process of transformation, where young adults are increasingly fewer, thus raising the question of who will take care of the elderly in the 21st Century? There is an urgent need to establish care networks for the elderly, covering primary care, including care with housing (Healthy Housing), as well as to ensure access to secondary and tertiary levels of care, providing early diagnoses and rapid access to treatment. This article reports two Brazilian experiences: the restructuring of a shelter for elderly indigents, with 500 elderly residents in Rio de Janeiro, which involved a broad process of humanization, with strong physical restructuring of the buildings that dated from 1930; and the process of organizing the care referral line for the elderly within the Conceição Hospital Group, in Rio Grande do Sul State, which included a health care complex with diverse health units, encompassing all stages of care: from primary care to the most complex hospital treatment.

Does a waiting room video about what to expect during an emergency department visit improve patient satisfaction?

ABSTRACT Objective: We created an instructional waiting room video that explained what patients should expect during their emergency department (ED) visit and sought to determine whether preparing patients using this video would 1) improve satisfaction, 2) decrease perceived waiting room times and 3) increase calls to an outpatient referral line in an ambulatory population. Methods: This serial cross-sectional study took place over a period of 2 months before (control) and 2 months after the introduction of an educational waiting room video that described a typical patient visit to our ED. We enrolled a convenience sample of adult patients or parents of pediatric patients who were triaged to the ED waiting room; a research assistant distributed and collected the surveys as patients were being discharged after treatment. Subjects were excluded if they were admitted. The primary outcome was overall satisfaction measured on a 5-point Likert scale, and secondary outcomes included perceived waiting room time, and the number of outpatient referral-line calls. Results: There were 1132 subjects surveyed: 551 prevideo and 581 postvideo. The mean age was 38 years (standard deviation [SD] 18), 61% were female and the mean ED length of stay was 5.9 hours (SD 3.6). Satisfaction scores were significantly higher postvideo, with 65% of participants ranking their visit as either “excellent” or “very good,” compared with 58.1% in the prevideo group (p = 0.019); however, perceived waiting room time was not significantly different between the groups (p = 0.24). Patient calls to our specialty outpatient clinic referral line increased from 1.5 per month (95% confidence interval [CI] 0.58–2.42) to 4.5 per month (95% CI 1.19–7.18) (p = 0.032). After adjusting for possible covariates, the most significant determinants of overall satisfaction were perceived waiting room time (odds ratio [OR] 0.41, 95% CI 0.34–0.48) and having seen the ED waiting room video (OR 1.41, 95% CI 1.06–1.86). Conclusion: Preparing patients for their ED experience by describing the ED process of care through a waiting room video can improve ED patient satisfaction and the knowledge of outpatient clinic resources in an ambulatory population. Future studies should research the implementation of this educational intervention in a randomized fashion.