scholarly journals Emergency department infectious diseases quick reference guide for use in regional health services

2016 ◽  
Vol 21 (3) ◽  
pp. 126
Author(s):  
Sue Atkins
Keyword(s):  
Emergency Department ◽  
Health Services ◽  
Infectious Diseases ◽  
Regional Health ◽  
Reference Guide

scholarly journals Acute mental health presentations before and during the COVID-19 pandemic

BJPsych Open ◽  
2021 ◽  
Vol 7 (4) ◽  
Author(s):  
Naaheed Mukadam ◽  
Andrew Sommerlad ◽  
Jessica Wright ◽  
Abigail Smith ◽  
Aleksandra Szczap ◽  
...  
Keyword(s):  
Mental Health ◽  
Emergency Department ◽  
Mental Health Services ◽  
Health Services ◽  
Psychological Symptoms ◽  
Interrupted Time Series ◽  
Psychiatric Services ◽  
Psychotic Symptoms ◽  
Duration Of Symptoms ◽  
Mental Capacity Act

Background A number of community based surveys have identified an increase in psychological symptoms and distress but there has been no examination of symptoms at the more severe end of the mental health spectrum. Aims We aimed to analyse numbers and types of psychiatric presentations to inform planning for future demand on mental health services in light of the COVID-19 pandemic. Method We analysed electronic data between January and April 2020 for 2534 patients referred to acute psychiatric services, and tested for differences in patient demographics, symptom severity and use of the Mental Health Act 1983 (MHA), before and after lockdown. We used interrupted time-series analyses to compare trends in emergency department and psychiatric presentations until December 2020. Results There were 22% fewer psychiatric presentations the first week and 48% fewer emergency department presentations in the first month after lockdown initiated. A higher proportion of patients were detained under the MHA (22.2 v. 16.1%) and Mental Capacity Act 2005 (2.2 v. 1.1%) (χ2(2) = 16.3, P < 0.0001), and they experienced a longer duration of symptoms before seeking help from mental health services (χ2(3) = 18.6, P < 0.0001). A higher proportion of patients presented with psychotic symptoms (23.3 v. 17.0%) or delirium (7.0 v. 3.6%), and fewer had self-harm behaviour (43.8 v. 52.0%, χ2(7) = 28.7, P < 0.0001). A higher proportion were admitted to psychiatric in-patient units (22.2 v. 18.3%) (χ2(6) = 42.8, P < 0.0001) after lockdown. Conclusions UK lockdown resulted in fewer psychiatric presentations, but those who presented were more likely to have severe symptoms, be detained under the MHA and be admitted to hospital. Psychiatric services should ensure provision of care for these patients as well as planning for those affected by future COVID-19 waves.

scholarly journals Electronic health records in ambulances: the ERA multiple-methods study

2020 ◽  
Vol 8 (10) ◽  
pp. 1-140
Author(s):  
Alison Porter ◽  
Anisha Badshah ◽  
Sarah Black ◽  
David Fitzpatrick ◽  
Robert Harris-Mayes ◽  
...  
Keyword(s):  
Emergency Department ◽  
Health Services ◽  
Electronic Health Records ◽  
Case Studies ◽  
Routine Data ◽  
Health Economy ◽  
Multiple Methods ◽  
Health Records ◽  
Electronic Health ◽  
Future Work

Background Ambulance services have a vital role in the shift towards the delivery of health care outside hospitals, when this is better for patients, by offering alternatives to transfer to the emergency department. The introduction of information technology in ambulance services to electronically capture, interpret, store and transfer patient data can support out-of-hospital care. Objective We aimed to understand how electronic health records can be most effectively implemented in a pre-hospital context in order to support a safe and effective shift from acute to community-based care, and how their potential benefits can be maximised. Design and setting We carried out a study using multiple methods and with four work packages: (1) a rapid literature review; (2) a telephone survey of all 13 freestanding UK ambulance services; (3) detailed case studies examining electronic health record use through qualitative methods and analysis of routine data in four selected sites consisting of UK ambulance services and their associated health economies; and (4) a knowledge-sharing workshop. Results We found limited literature on electronic health records. Only half of the UK ambulance services had electronic health records in use at the time of data collection, with considerable variation in hardware and software and some reversion to use of paper records as services transitioned between systems. The case studies found that the ambulance services’ electronic health records were in a state of change. Not all patient contacts resulted in the generation of electronic health records. Ambulance clinicians were dealing with partial or unclear information, which may not fit comfortably with the electronic health records. Ambulance clinicians continued to use indirect data input approaches (such as first writing on a glove) even when using electronic health records. The primary function of electronic health records in all services seemed to be as a store for patient data. There was, as yet, limited evidence of electronic health records’ full potential being realised to transfer information, support decision-making or change patient care. Limitations Limitations included the difficulty of obtaining sets of matching routine data for analysis, difficulties of attributing any change in practice to electronic health records within a complex system and the rapidly changing environment, which means that some of our observations may no longer reflect reality. Conclusions Realising all the benefits of electronic health records requires engagement with other parts of the local health economy and dealing with variations between providers and the challenges of interoperability. Clinicians and data managers, and those working in different parts of the health economy, are likely to want very different things from a data set and need to be presented with only the information that they need. Future work There is scope for future work analysing ambulance service routine data sets, qualitative work to examine transfer of information at the emergency department and patients’ perspectives on record-keeping, and to develop and evaluate feedback to clinicians based on patient records. Study registration This study is registered as Health and Care Research Wales Clinical Research Portfolio 34166. Funding This project was funded by the National Institute for Health Research (NIHR) Health Services and Delivery Research programme and will be published in full in Health Services and Delivery Research; Vol. 8, No. 10. See the NIHR Journals Library website for further project information.

scholarly journals The Clinical Frailty Scale and Health Services Use for Older Adults in the Emergency Department

2020 ◽  
Author(s):  
Peter Serina ◽  
Alexander X. Lo ◽  
Masha Kocherginsky ◽  
Elizabeth Gray ◽  
Lee A. Lindquist ◽  
...  
Keyword(s):  
Older Adults ◽  
Emergency Department ◽  
Health Services ◽  
Health Services Use ◽  
Clinical Frailty Scale ◽  
Services Use
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