scholarly journals P115: Bounceback reports-improving patient care

CJEM ◽  
2018 ◽  
Vol 20 (S1) ◽  
pp. S97-S98
Author(s):  
F. Pinto ◽  
M. B-Lajoie
Keyword(s):  
Online Survey ◽  
Response Rate ◽  
Clinical Skills ◽  
High Yield ◽  
Academic Hospital ◽  
Outcome Feedback ◽  
Improving Patient Care ◽  
The Impact ◽  
Final Disposition

Introduction: Seeking patient outcome feedback (POF), defined as obtaining information on a patients clinical course beyond ones care, is crucial to the learning process. However, the lack of POF is a major pitfall of emergency medicine. Emergency department (ED) bouncebacks, which are characterized as patients with unplanned returns to the ED after being discharged, are an important type of POF to study because they represent a potential misdiagnosis or mismanagement and can highlight areas for physician self-improvement. Currently, most hospitals do not relay details about ED bouncebacks back to the treating physician, unless a grave error occurred. This studys purpose is to provide weekly reports to all physicians in the ED on patients who have unplanned returns within 7 days of discharge from the ED, and evaluate the impact this has on the physicians practice on seeking POF. Methods: A new weekly report was distributed to physicians working at an academic hospital outlining the patients who have returned within 7 days of discharge from the ED, their new presenting complaint and final disposition. An online survey was also administered to all ED staff evaluating the amount of POF they sought pre and post report, and their attitude towards the new reports. Results: 22 responses were received, for a response rate of 85%. The majority of respondents follow the reports (73%) and actively seek POF by looking up patients charts and results(70%). Additionally, 58% state that they seek POF more often since receiving these reports, for both the bouncebacks and their other patients. Furthermore, 37% claimed that the reports helped improve the appropriateness of their referrals and 32% stated it helped increase their confidence in their clinical practice. The majority of physicians (87%) found the reports to be helpful and would like to continue receiving it. Conclusion: Weekly bounceback reports are a high-yield tool for increasing POF sought in the ED and have benefits for both the physician and the department as a whole. They can be used to not only identify patients who may have had an error in their management, but also help to improve physicians’ clinical skills by encouraging and enabling follow-up of patients they managed. Thus, bounceback reports are a valuable tool to provide to physicians and should be considered by ED Departments.

scholarly journals Evaluating the Impact of Training Health Professionals to Deliver Brief Motivational and Skills-Based Interventions for Cannabis Use Disorder

2012 ◽  
Vol 2 ◽  
Author(s):  
Dion Alperstein ◽  
Jan Copeland
Keyword(s):  
Clinical Training ◽  
Health Workers ◽  
Clinical Skills ◽  
Cannabis Use ◽  
Evidence Based ◽  
Transfer Of Knowledge ◽  
Evidence Based Treatment ◽  
Cognitive Behavioural ◽  
The Impact

Background: While there is considerable evidence that brief motivational and skills-based interventions for substance use are effective, little is known regarding the transfer of knowledge from research to practice. This study aims to evaluate the effectiveness of two half-day didactic clinical training workshops for allied health workers, which did not incorporate feedback or supervision, via independent follow-up three months post training.Methods: In total, 1322 participants attended either or both of the evidence-based treatment workshops run by the National Cannabis Prevention and Information Centre. Of those participants, 495 (37%) completed an online follow-up evaluation three months later regarding their use of the newly learnt intervention(s).Results: At follow-up, 270 (54.5%) participants had an opportunity to use the skills and 144 (53.3%) of those participants reported having used the clinical skills taught in the workshop. Of those who used one of the interventions, 90 (62.5%) participants reported their clients had reduced or quit their cannabis use. Furthermore, 43 (30%) of these participants had attempted to train others in the workplace in the techniques learnt in the workshop.Conclusion: Even a half-day didactic clinical training workshop on evidence-based brief cognitive–behavioural techniques delivered to clinicians working in the field can improve knowledge and confidence among clinicians and outcomes among their clients with cannabis use related problems.

scholarly journals P–759 The impact of the COVID–19 pandemic on women seeking fertility treatment in Germany: the patient´s perspective

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
S Wedner-Ross ◽  
F Vo. Versen-Höynck
Keyword(s):  
Study Design ◽  
Online Survey ◽  
Fertility Treatment ◽  
Unborn Child ◽  
Negative Effects ◽  
Cross Sectional ◽  
Professional Societies ◽  
Fertility Treatments ◽  
The Impact

Abstract Study question This cross-sectional survey sought the views of women seeking fertility treatment on the impact of the COVID–19 pandemic on their fertility treatment and attitudes. Summary answer Most respondents worried the recommendations to postpone treatment would reduce their chances of pregnancy and were concerned about negative effects of SARS-Cov–2 infections on pregnancy. What is known already In spring 2020, the recommendations of ESHRE and German professional societies to postpone fertility treatments resulted in limited or closed services from mid-March to early May in many clinics. Previous studies reported that postponing fertility clinic appointments causes psychological distress, with most patients saying they would have preferred to continue treatment. While no similar studies are available from Germany, where COVID–19 incidence was relatively low, concerns of the patients about possible consequences of a treatment delay and a SARS-CoV–2 infection on fertility and pregnancy remain unknown. Study design, size, duration This cross-sectional, anonymous, online questionnaire was completed in June-December 2020 by 249 women attending fertility clinics across Germany. The women were recruited using leaflets, directly by study personnel either in person or by telephone, or via online support group forums for fertility patients. Participants/materials, setting, methods All women seeking treatment in fertility clinics were eligible to participate. The online survey covered questions about the patient’s quality of life, their opinions about the professional societies’ recommendations and their effects as well as any concerns about infection with SARS-CoV–2. Statistical analysis was conducted using SPSS Version 27. Main results and the role of chance Three-quarters of participants disagreed with the pausing of fertility treatments. Women who participated from October-December 2020, when the incidence rate was high, were as likely to disagree as participants that participated from June-September 2020 (73% vs 79%, p = 0.3). Nearly all participants (95%) were concerned that treatment delays would reduce their chances of pregnancy. 72 participants (29%) had their appointments cancelled. Nearly all (97%) reported being upset by this, with 40 (56%) reporting that they were extremely or very disappointed about the cancellation. Women coming for follow-up appointments and women who had to wait 10 weeks or longer were more likely to be upset by the postponement or cancellation of their appointment (p = 0.016 and p = 0.012, respectively). Nearly all (97%) of the participants were worried about possible negative effects a SARS-CoV–2 infection might have related to their fertility, pregnancy or unborn child. Sixty-one percent stated they were very or moderately concerned about the negative influence the infection might have on the womańs own health during pregnancy and 60% were very to moderately concerned about potential negative effects for the unborn child. However, only 26% reported they were very or moderately concerned about the potential negative effects of an infection on fertility. Limitations, reasons for caution The main limitations of this study are the possibility of selection bias as people with strong opinions are more likely to have participated and the lack of information on non-responders due to the study design. Also, the Covid–19 pandemic is evolving continuously meaning that participantś opinions may vary over time. Wider implications of the findings: Postponement of treatments increased distress among patients and should be avoided when possible. If unavoidable, follow-up patients should be prioritised for treatment and the length of postponement should be minimised. Fertility clinics must provide information about the current state of knowledge of SARS-Cov–2 infections in pregnancies and options for immunization. Trial registration number Not applicable

scholarly journals Response Pressure And Uninformed Responses To Factual Survey Questions

2011 ◽  
Vol 3 (3) ◽  
pp. 146
Author(s):  
Kenneth C. Schneider ◽  
James C. Johnson
Keyword(s):  
Response Rate ◽  
Survey Response ◽  
Survey Response Rate ◽  
Survey Questions ◽  
Response Pressure ◽  
The Impact

This article examines the impact of follow-up techniques (designed to increase the survey response rate) on uninformed responses to factual survey questions. Such questions of fact can be used as filters to measures a respondents base of information, knowledge or experience on a topic prior to measuring his/her opinions on that topic, but only if uninformed responses are less likely to be given to the factual filter questions than to the opinion/attitude questions. Previous research suggests that response pressure (including follow-up contact) tends to exacerbate the uninformed response rate to opinion or attitude questions. However, the research reported here suggests that is not so with factual questions; follow-up contract does not result in increased levels of uninformed response to questions of fact.

How do hand therapists conservatively manage acute, closed mallet finger? A survey of members of the British Association of Hand Therapists

Hand Therapy ◽  
2016 ◽  
Vol 22 (1) ◽  
pp. 13-25 ◽  
Author(s):  
Samantha Cook ◽  
Nikki Daniels ◽  
Sarah Woodbridge
Keyword(s):  
Best Practice ◽  
Online Survey ◽  
Response Rate ◽  
Clinical Skills ◽  
Current Treatment ◽  
Therapeutic Management ◽  
British Association ◽  
Mallet Finger ◽  
Clinical Practices ◽  
Diverse Range

Introduction Previous research concerning the conservative management of mallet finger has focused on splint application, with limited representation of supplementary rehabilitation and best practice. This research sought to investigate the practice and opinions of members of the British Association of Hand Therapists regarding their current treatment and to determine whether any specific exercise prescription or rehabilitation protocols are followed. Methods British Association of Hand Therapists members were contacted via e-mail and requested to complete an online survey. Thirty-five responses (5.7% response rate), 30 (4.8% response rate) of which were fully completed were obtained over the eight-week data collection period. The questionnaire consisted of 30 questions (20 quantitative and 10 qualitative) concerning therapists’ roles and condition management. Responses were analysed in terms of response frequencies, percentages and thematic text analysis. Results The results demonstrated current clinical practices in line with available best-evidenced practice. Conservative therapeutic management is diverse and varied. Therapists believe their role to be significant in optimising outcome success. Discussion Exercises and other interventions supplementary to splinting are commonly utilised in the therapeutic management of acute, closed mallet finger. This research found hand therapists implement a diverse range of clinical skills in order to optimise outcome success. Recommendations for best practice and further research are presented.

scholarly journals Impact of COVID-19 on Malaysian Dental Students’ Physical, Mental, Financial and Academic Concerns

2021 ◽  
Author(s):  
Widya Lestari ◽  
Nur Hazirah Yazid ◽  
Zawin Najah Azhar ◽  
Azlini Ismail ◽  
Cortino Sukotjo
Keyword(s):  
Online Survey ◽  
Clinical Skills ◽  
Clinical Skill ◽  
Cross Sectional Study ◽  
Dental Students ◽  
Health Concern ◽  
Financial Health ◽  
Cross Sectional ◽  
Novel Coronavirus ◽  
The Impact

Abstract Background The coronavirus disease 2019 (COVID-19) caused by a novel coronavirus (SARS-CoV-2) has spread across the world at unprecedented speed and gained worldwide attention. The pandemic proved to hold an impact to humankind including dental students in all aspects of life. Dental students’ performances may indirectly be affected following the preventive measures in containing the disease. This study aims to evaluate the impact of COVID-19 pandemic on physical, mental, financial health and academic concern among dental students in Malaysia. Methods The current research implemented a cross sectional study among dental students in Malaysia. Assessment of the impact of COVID-19 on dental education was done by the distribution of a set of online survey consisting of 28 questions to dental students (n = 353) from public and private universities in Malaysia. The questionnaires include sociodemographic backgrounds and assessment on the 4 main domains. Results A total number of 353 respondents was recorded and 76.2% comprised of female. 59.7% were clinical students and 40.3% were preclinical students. 55.8% of the respondents attended hybrid mode of study. 78.0%, 76.5% and 91.8% students were concerned about their own emotional, physical health and the amount of clinical skill they acquire respectively. Year 3 students were found to be more concerned about their mental and financial health concern (p < 0.05). Conclusions COVID-19 pandemic had indeed significantly affected Malaysian dental students mainly due to fear of the quality of online learning and the amount of clinical skills acquired.

scholarly journals Predicting the Willingness of Nurses to Work with COVID-19 Patients: The Impact of Knowledge and Attitude

2020 ◽  
Author(s):  
Abdulqadir J. Nashwan ◽  
Ahmad A. Abujaber ◽  
Ahmed S. Mohamed ◽  
Ralph C. Villar ◽  
Mahmood M. Al-Jabry
Keyword(s):  
Online Survey ◽  
Response Rate ◽  
High Risk Patient ◽  
Cross Sectional ◽  
Nursing Leaders ◽  
Patient Groups ◽  
Main Factors ◽  
Knowledge And Attitude ◽  
The Impact ◽  
Nurses And Midwives

Abstract Aim: This study aims to assess the impact of nurses’ knowledge and attitude toward Coronavirus Disease 2019 (COVID-19) as a predictor for their willingness to work with patients diagnosed with COVID-19 in Qatar. Design: A cross-sectional study.Methods: A self-administered, 35-item online survey was circulated to the registered nurses and midwives working in Hamad Medical Corporation; the principle healthcare provider in Qatar. Results: A total of 580 attempts to complete the survey. Of them, 377 completed surveys with a response rate of 65%. Logistic regression was used to predict nurses’ willingness to work with patients with COVID-19. Two main factors were found to be significant predictors for nurses’ willingness; knowledge level and the expected remuneration that is associated with the level of exposure to risk. The findings of this study may help nursing leaders design educational programs and remuneration models that may help boost nurses’ willingness to work with high-risk patient groups, especially during crisis situations.

scholarly journals The Impact of Resilience and Extraversion on Psychological Distress, Loneliness, and Boredom During the COVID-19 Pandemic: A Follow-Up Study Among the General Population of Tyrol, Austria

2021 ◽  
Vol 12 ◽  
Author(s):  
Franziska Tutzer ◽  
Beatrice Frajo-Apor ◽  
Silvia Pardeller ◽  
Barbara Plattner ◽  
Anna Chernova ◽  
...  
Keyword(s):  
Psychological Distress ◽  
General Population ◽  
Online Survey ◽  
Short Form ◽  
Negative Association ◽  
Mitigation Strategies ◽  
Protective Effects ◽  
Resilience Scale ◽  
The Impact

Background: The Covid-19 pandemic and related measures represent an enormous burden on mental health. The aim of this study was to investigate longitudinal changes in psychological distress, loneliness, boredom, and resilience over the course of the pandemic and to examine the associations between resilience and extraversion at baseline (summer 2020) and psychological distress, loneliness, and boredom at 5-month-follow-up.Methods: Residents of Tyrol (≥18a) completed an online survey on psychological distress, loneliness, boredom, resilience, and extraversion by using the Brief-Symptom-Checklist, the Three-Item Loneliness Scale, the Multidimensional State Boredom Scale-Short Form (MSBS-SF), the Resilience Scale, and the Extraversion subscale of the Big Five Inventory.Results: Of the 961 baseline participants, 384 took part in the follow-up survey. The percentage of study participants with striking psychological distress remained the same. Similarly, resilience did not change from baseline to follow-up, whereas the number of those experiencing moderate loneliness increased significantly. In contrast, at follow-up, severe loneliness was detected in significantly less people. Boredom decreased significantly over time. A moderate negative association was detected between baseline resilience and psychological distress, loneliness, and boredom at follow-up, and a weak but still significant negative association between extraversion and these outcomes.Discussion: These findings indicate that a subset of the general population consistently suffers from high levels of psychological distress and point to the protective effects of resilience and extraversion in this context. They reemphasize the importance of prevention and mitigation strategies to address these public health problems.

P578Multipoint pacing in cardiac resynchronization therapy - how to improve remodeling criteria and its impact in quality of life

EP Europace ◽  
2020 ◽  
Vol 22 (Supplement_1) ◽  
Author(s):  
A Nunes Ferreira ◽  
P S Antonio ◽  
I Aguiar-Ricardo ◽  
T Rodrigues ◽  
N Cunha ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Response Rate ◽  
Reverse Remodeling ◽  
Resynchronization Therapy ◽  
Rate Reduction ◽  
Systolic Volume ◽  
End Systolic Volume ◽  
The Impact

Abstract Background Despite the reduction in mortality and hospitalization rates, resynchronization therapy still has 30-40% of non-responders. Several studies are ongoing to evaluate if novel programming techniques such as multipoint pacing (MPP) increase the conversion rate of non-responder to responder to CRT. However, there is still lack of information about conversion to super-responders and the impact in quality of life of MPP. Purpose To evaluate the impact of MPP in conversion to super-responders and its impact in the quality of life of patients. Methods Randomized clinical trial of non-AF patients with indication for CRT and who implanted the Quartet™ quadripolar left ventricle (LV) lead. After implant, CRTs were programmed on biventricular pacing according to the latest activated area for 6 months. After a 6-month follow-up, patients were randomized in a 1:1 fashion to MPP ON or MPP OFF. MPP was programmed with the two widest spaced LV electrodes and with a LV1-LV2 to LV2-RV delay of 5ms. Patients were followed-up for 12 months with a 6-month evaluation of NTproBNP, echocardiographic remodeling criteria (LV end systolic volume (ESV) and LV ejection fraction), and quality of life (QoL) evaluated by EQ-5D, Minnesota Living with Heart Failure (MLWHF) questionnaire and 6-minute walk test (6MWT). Results  76 patients were included in this trial, 62 with a completed 12-month follow-up (average age 67.2 ± 10.2 years old, 32.3% female gender, dilated cardiomyopathy in 77.4%). Among these patients, 24 were randomized to MPP ON, 28 to MPP OFF. Six patients died and 4 were lost to follow-up. Baseline clinical and echocardiographic characteristics were similar between groups (p = NS). At 6 months, the overall response rate (reduction in ESV≥15%) was 75%. At twelve months, patients randomized to MPP ON had a super-response rate (reduction in ESV≥30%) higher than patients with MPP OFF (75% vs 39.3%, p = 0.01). Between 6-12 months, patients assigned to MPP ON had a higher reduction in ESV (93.4 ± 52.3mL to 82.1 ± 40.5mL, p = 0.04) and an improvement in LVEF (38.3 ± 9.8% to 45.1 ± 11.1%, p &lt; 0.01) compared to patients with MPP OFF (92.2 ± 47.3mL to 95.4 ± 47.5mL, p = NS; 37.1 ± 12.0% to 40.2 ± 9.2%, p = NS). Additionally, QoL of patients with MPP ON improved during follow up (EQ-5D 78.3% to 86.3%, p &lt; 0.01; MLWHF 12.1 to 6.6, p = 0.03, 6MWT 316m to 239m, p = NS; NTproBNP 1608 ± 2450pg/mL to 775 ± 914pg/mL, p = NS) and was unchanged in MPP OFF patients (76.6% to 74.2%; MLWHF 12.7 to 12.7; 6MWT 338m to 299m, NTproBNP 1112 ± 1442pg/mL to 1383 ± 2118pg/mL, for all p = NS). Conclusion In our population, patients with CRT programmed with MPP ON, when compared to MPP OFF, had an improvement in the super-response rate and in quality of life. These results may be consequence from a more favorable reverse remodeling due to MPP, with a higher reduction in the LV end systolic volume. Abstract Figure.

scholarly journals P094: Meeting patient expectations in the emergency department: preliminary findings from the preparing emergency patients and providers study

CJEM ◽  
2017 ◽  
Vol 19 (S1) ◽  
pp. S110
Author(s):  
J. Nunn ◽  
C. Cassidy ◽  
D. Chiasson ◽  
S. MacPhee ◽  
J. Curran
Keyword(s):  
Emergency Department ◽  
Response Rate ◽  
Phase 1 ◽  
Patient Expectations ◽  
Satisfaction With Care ◽  
Medical Encounter ◽  
X Ray ◽  
Phase Study ◽  
The Impact

Introduction: Effective communication to develop a shared understanding of patient expectations is critical in establishing a positive medical encounter in the emergency department (ED). However, there is limited research examining patient/caregiver expectations in the ED, and their impact on the beliefs, attitudes and behaviours during and after an ED visit. The objective of this study is to examine patient/caregiver expectations and satisfaction with care in the ED using a patient expectation questionnaire and a follow up survey. Methods: As a part of a larger 3-phase study on patient/caregiver expectations in adult and pediatric EDs, a 7-item, paper-based questionnaire was distributed to all patients and/or caregivers who presented to one of four EDs in Nova Scotia with a Canadian Triage and Acuity Scale (CTAS) score of 2 to 5. A follow-up survey was distributed to all willing participants via email to determine their satisfaction with care received in ED. Descriptive statistics were used to analyze responses. Results: Phase 1 was conducted from January to September 2016. In total, 24,788 expectation questionnaires were distributed to ED patients/caregivers, 11,571 were collected (47% response rate), and 509 patients were contacted for a follow-up survey. Preliminary analysis of 4,533 questionnaires shows the majority of patients (67.1%) made the decision by themselves to present to the ED, while others were advised by a family/friend (22%). Respondents were most worried about an injury (17.8%) followed by illness (15.6%) and expected to talk to a physician (69.9%) and receive an x-ray (39.3%). The majority of physicians (53.3%) reported the expectation tool helped in caring for the patient and 87.5% felt they met patient expectations. There were 147 patient/caregiver responses to a follow-up survey (29% response rate) and 87.1% of responders reported that ED clinicians met their expectations. Conclusion: Patient/caregivers have a variety of concerns, questions, and expectations when presenting to the ED. Obtaining expectations early in the patient encounter may provide opportunities for improved communication between clinicians and patients while enhancing satisfaction with care received. Further analysis is needed to determine the impact of the expectation questionnaire on productivity in the ED.

scholarly journals P105: Patient outcome feedback in emergency medicine

CJEM ◽  
2016 ◽  
Vol 18 (S1) ◽  
pp. S113-S113
Author(s):  
F. Pinto ◽  
M. B-Lajoie
Keyword(s):  
Patient Outcome ◽  
Emergency Medicine ◽  
Online Survey ◽  
Clinical Care ◽  
Final Diagnosis ◽  
Outcome Feedback ◽  
Negative Results ◽  
Imaging Results ◽  
Improving Patient Care ◽  
Electronic Tracking

Introduction: Emergency medicine (EM) is characterized by one time patient encounters where the end diagnosis is often unknown. Seeking patient outcome feedback, (POF) which is defined as following a patient’s clinical course once they leave your care, is crucial as it can highlight a discord between an intended verses actual result, thus spurring clinical change. This study seeks to determine whether EM staff and residents currently seek POF, the types of patients followed and the barriers faced. Methods: An online survey was administered to all EM staff and residents (CCFP-EM and FRCP) working at a tertiary academic hospital to determine their current practices and attitudes towards POF. Results: A total of 72 responses were received, of which 41 were residents and 31 were staff, for an overall response rate of 95%. If feedback was sought, the most commonly used tools were looking up imaging results (52%) and talking to EM colleagues (42%). The patients most frequently followed were those with a poor outcome during their ED admission, sick patients with unclear final diagnosis or unplanned returns within 48 hours (55%, 58%, 34% respectively). However, up to 30% of respondents never or rarely sought out POF even in these situations (16%, 19% and 30% respectively). Patients least commonly followed were those where the diagnosis was more certain. Respondents identified many barriers, primarily being time (83%), not being notified about bouncebacks (79%) and remembering which patients to follow (70%). Barriers were amplified for residents as they had a harder time accessing or automatically receiving POF. The most useful tools not currently available, would be being able to easily create electronic tracking lists, being automatically sent discrepant imaging reports and automatic notification of patients who return to the ED within 48hrs. Also, automatic follow up information on patients who experienced a negative outcome or on sick patients with unclear diagnosis is desired. Conclusion: POF is a useful and crucial practice for clinical care, but is currently not often performed. The most commonly used tools are those that are easiest to access, and POF was mainly performed on patients with either negative results or unclear diagnoses. Thus, identifying the types of patients deemed most relevant for receiving POF and addressing the major barriers faced by clinicians can help improve the frequency with which POF is sought, potentially improving patient care.

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