scholarly journals Understanding the impact of simulated patients on health care learners’ communication skills: a systematic review

2017 ◽  
Vol 51 (12) ◽  
pp. 1209-1219 ◽  
Author(s):  
Jessica Kaplonyi ◽  
Kelly-Ann Bowles ◽  
Debra Nestel ◽  
Debra Kiegaldie ◽  
Stephen Maloney ◽  
...  
Keyword(s):  
Systematic Review ◽  
Health Care ◽  
Communication Skills ◽  
Simulated Patients ◽  
The Impact

scholarly journals P070: Mixed effectiveness of emergency department diversion strategies: a systematic review

CJEM ◽  
2017 ◽  
Vol 19 (S1) ◽  
pp. S102
Author(s):  
S.W. Kirkland ◽  
A. Soleimani ◽  
B.H. Rowe ◽  
A.S. Newton
Keyword(s):  
Systematic Review ◽  
Health Care ◽  
Emergency Department ◽  
Health Care Services ◽  
Grey Literature ◽  
Study Data ◽  
Care Utilization ◽  
Alternative Source ◽  
Increased Risk ◽  
The Impact

Introduction: Diverting patients away from the emergency department (ED) has been proposed as a solution for reducing ED overcrowding. The objective of this systematic review is to examine the effectiveness of diversion strategies designed to either direct patients seeking care at an ED to an alternative source of care. Methods: Seven electronic databases and grey literature were searched. Randomized/controlled clinical trials and cohort studies assessing the effectiveness of pre-hospital and ED-based diversion interventions with a comparator were eligible for inclusion. Two reviewers independently screened the studies for relevance, inclusion, and risk of bias. Intervention effects are reported as proportions (%) or relative risks (RR) with 95% confidence intervals (CI). Methodological and clinical heterogeneity prohibited pooling of study data. Results: From 7,306 citations, ten studies were included. Seven studies evaluated a pre-hospital diversion strategy and three studies evaluated an ED-based diversion strategy. The impact of diversion on subsequent health services was mixed. One study of paramedic practitioners reported increased ED attendance within 7 days (11.9% vs. 9.5%; p=0.049) but no differences in return visits for similar conditions (75.2% vs. 72.1%; p=0.64). The use of paramedic practitioners was associated with an increased risk of subsequent contact with health care services (RR=1.21, 95% CI 1.06, 1.38), while the use of deferred care was associated with no increase in risk of subsequently seeking physician care (RR=1.09, 95% CI 0.23, 5.26). While two studies reported that diverted patients were at significantly reduced risk for hospitalization, two other studies reported no significant differences between diverted or standard care patients. Conclusion: The evidence regarding the impact of pre-hospital and ED-based diversion on ED utilization and subsequent health care utilization is mixed. Additional high-quality comparative effectiveness studies of diversion strategies are required prior to widespread implementation.

scholarly journals Ageing, limb-loss and military veterans: a systematic review of the literature

2018 ◽  
Vol 39 (8) ◽  
pp. 1582-1610 ◽  
Author(s):  
NICK CADDICK ◽  
HELEN CULLEN ◽  
AMANDA CLARKE ◽  
MATT FOSSEY ◽  
MICHAEL HILL ◽  
...  
Keyword(s):  
Systematic Review ◽  
Health Care ◽  
Military Service ◽  
Military Veterans ◽  
Limb Loss ◽  
Cochrane Library ◽  
Term Care ◽  
Long Term Impact ◽  
The Impact

ABSTRACTThe impact of losing a limb in military service extends well beyond initial recovery and rehabilitation, with long-term consequences and challenges requiring health-care commitments across the lifecourse. This paper presents a systematic review of the current state of knowledge regarding the long-term impact of ageing and limb-loss in military veterans. Key databases were systematically searched including: ASSIA, CINAHL, Cochrane Library, Medline, Web of Science, PsycArticles/PsychInfo, ProQuest Psychology and ProQuest Sociology Journals, and SPORTSDiscus. Empirical studies which focused on the long-term impact of limb-loss and/or health-care requirements in veterans were included. The search process revealed 30 papers relevant for inclusion. These papers focused broadly on four themes: (a) long-term health outcomes, prosthetics use and quality of life; (b) long-term psycho-social adaptation and coping with limb-loss; (c) disability and identity; and (d) estimating the long-term costs of care and prosthetic provision. Findings present a compelling case for ensuring the long-term care needs and costs of rehabilitation for older limbless veterans are met. A dearth of information on the lived experience of limb-loss and the needs of veterans’ families calls for further research to address these important issues.

The Impact of the SAGE & THYME Foundation Level Workshop on Factors Influencing Communication Skills in Health Care Professionals

2014 ◽  
Vol 34 (1) ◽  
pp. 37-46 ◽  
Author(s):  
Michael Connolly ◽  
Joanne M. Thomas ◽  
Julie A. Orford ◽  
Nicola Schofield ◽  
Sigrid Whiteside ◽  
...  
Keyword(s):  
Health Care ◽  
Communication Skills ◽  
Health Care Professionals ◽  
Factors Influencing ◽  
The Impact

scholarly journals Effects of electronic health record use on the exam room communication skills of resident physicians: a randomized within-subjects study

2014 ◽  
Vol 22 (1) ◽  
pp. 192-198 ◽  
Author(s):  
Teresa Taft ◽  
Leslie Lenert ◽  
Farrant Sakaguchi ◽  
Gregory Stoddard ◽  
Caroline Milne
Keyword(s):  
Internal Medicine ◽  
Communication Skills ◽  
Simulated Patients ◽  
First Year ◽  
Laptop Computer ◽  
Internal Medicine Training ◽  
Paper Chart ◽  
Within Subjects ◽  
Electronic Health ◽  
The Impact

Abstract Background The effects of electronic health records (EHRs) on doctor–patient communication are unclear. Objective To evaluate the effects of EHR use compared with paper chart use, on novice physicians’ communication skills. Design Within-subjects randomized controlled trial using observed structured clinical examination methods to assess the impact of use of an EHR on communication. Setting A large academic internal medicine training program. Population First-year internal medicine residents. Intervention Residents interviewed, diagnosed, and initiated treatment of simulated patients using a paper chart or an EHR on a laptop computer. Video recordings of interviews were rated by three trained observers using the Four Habits scale. Results Thirty-two residents completed the study and had data available for review (61.5% of those enrolled in the residency program). In most skill areas in the Four Habits model, residents performed at least as well using the EHR and were statistically better in six of 23 skills areas (p<0.05). The overall average communication score was better when using an EHR: mean difference 0.254 (95% CI 0.05 to 0.45), p = 0.012, Cohen's d of 0.47 (a moderate effect). Residents scoring poorly (>3 average score) with paper methods (n = 8) had clinically important improvement when using the EHR. Limitations This study was conducted in first-year residents in a training environment using simulated patients at a single institution. Conclusions Use of an EHR on a laptop computer appears to improve the ability of first-year residents to communicate with patients relative to using a paper chart.

scholarly journals A Systematic Review of Usability Challenges and Testing in Mobile Health

2015 ◽  
Vol 5 (2) ◽  
pp. 1 ◽  
Author(s):  
Tareq Ali Al-Saadi ◽  
Tamer Mohammed Aljarrah ◽  
Anahed Mudheher Alhashemi ◽  
Azham Hussain
Keyword(s):  
Systematic Review ◽  
Health Care ◽  
Mobile Health ◽  
Mobile Communications ◽  
Digital Libraries ◽  
Health Care Professionals ◽  
Usability Testing ◽  
Smart Phones ◽  
Portable Devices ◽  
The Impact

Nowadays, the combining of advanced mobile communications and mobile account now in portable devices named "smart phones" has becomes more great uses. Among of these include health care professionals. Few studies in the challenge, blurred reality challenge facing the patient and developer alike in the usability of mobile health. Therefore, this paper aims to analyze the usability challenges in mobile health and usability testing. The systematic review was using for collecting the prior studies that relation with our study. This study concentrates on the three digital libraries Google scholar, ACM and IEEE, as well as, the researcher selected the studies between 2007 and 2015. The results from this systematic were selected 11 studies of 106 based on the inclusions criteria. In more details, the usability challenges found that 27% offered User Interface, 22% tasks and screen size, 16% insert media and 13% network. On the other hand, usability use found that, 46% of the selected studies the usability use of formal type of 45% informal and 9% mixed formal and informal. Sum up, the use of smart phones is getting more on health care and day out. Medical applications make smart phones useful tools in the practice of evidence-based medicine at the point of care, in addition to its use in mobile clinical communications. This study will making a contribution to the researchers to extract over the impact of the challenges on usability testing and the types of usability in mobile health.

scholarly journals Direct access physiotherapy for patients with musculoskeletal disorders: a systematic review

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
A Demont ◽  
A Bourmaud ◽  
A Kechichian ◽  
F Desmeules
Keyword(s):  
Systematic Review ◽  
Health Care ◽  
Adverse Events ◽  
Usual Care ◽  
Musculoskeletal Disorders ◽  
Health Care Costs ◽  
Family Physician ◽  
Direct Access ◽  
The Impact ◽  
Care Costs

Abstract Background Although the benefits of physiotherapy is well supported in the literature, the impact of having direct access to physiotherapy is not well established. Update of the current available evidence is warranted. The aim of this systematic review was to update the current evidence regarding the impact of direct access physiotherapy compared to usual care for patients with musculoskeletal disorders. Methods Systematic searches were conducted in 5 bibliographic databases up until May 2018. Two independent raters reviewed studies and used the Quality Assessment Tool for Quantitative Studies to conduct the methodological quality assessment and a data extraction regarding patient outcomes, adverse events, health care utilization and processes, patient satisfaction and health care costs. Results Sixteen studies of weak to moderate quality were included. Five studies found no significant differences in pain reduction between usual family physician led care and direct access physiotherapy. However, three studies reported better clinical outcomes in patients with direct access in terms of function and quality of life. Five studies did not observe any adverse events with direct access physiotherapy. Three studies showed shorter waiting time and four studies reported fewer number of physiotherapy visits with direct access. Three studies showed that patients with direct access were less likely to have medication and imaging tests prescribed compared to usual care. Five studies reported higher levels of satisfaction for direct access. In terms of health care costs, four studies demonstrated that costs were lower with direct access and one study reported similar costs between both types of care. Conclusions Emerging evidence, although of weak to moderate quality, suggest that direct access physiotherapy provides equal or better outcomes than family physician led care models for musculoskeletal disorders patients. More methodologically strong studies are needed. Key messages This review supports the efficacy, safety and cost-effectiveness of direct access PT, while increasing access to care with a more efficient use of resources. There is a need for more methodologically strong studies to evaluate the efficiency of direct access models of care of physiotherapy for patients with MSKD.

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