scholarly journals Clinical audit of the inclusion of the Lester Tool details in discharge documents at Foss Park Hospital, York

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S86-S86
Author(s):  
Kayleigh Jones ◽  
Shona McIlrae ◽  
Karen Ball ◽  
Rohma Tahir
Keyword(s):  
Life Expectancy ◽  
Physical Health ◽  
Cardiovascular Health ◽  
Smoking Status ◽  
Healthcare Services ◽  
Mental Illnesses ◽  
Care Providers ◽  
Cholesterol Ratio ◽  
Transfer Of Information ◽  
Park Hospital

AimsPatients with serious mental health illnesses die on average 15–20 years before the rest of the general population. Anti-psychotic medication, lifestyle and difficulty accessing healthcare services all have a detrimental effect on their life expectancy. To improve outcomes for these patients the Lester Tool; a method to assess the cardiovascular health of patients and implement change, was developed. Including the Lester Tool information in discharge letters allows transfer of information to other care providers (mainly GP's) who can implement and monitor any interventions made, improving outcomes for our patients. With this in mind, discharge documents should contain all of the information listed in the Lester Tool.We aimed to check if 100% of data required by the Lester Tool is included in discharge documents of the inpatients at Foss Park Hospital.Method20 patients from each of the male and female wards at Foss Park hospital, discharged in September or October 2020, were identified. A review of the discharge documents established whether the smoking status, BMI, ECG, blood pressure and blood results of each patient were recorded.ResultOf the 40 discharges, none had 100% compliance. On average across both wards; only 23% of the Lester tool information was included in the documents. On the female ward, 40% had none of data recorded, while on the male ward, 15% had none of the data recorded. Across both wards, not a single patient had details about their cholesterol ratio recorded, only 50% of BMI's were recorded and only 27% had a smoking status included.ConclusionOur results have shown that compliance with the Lester Tool falls short of what is expected. As a result, information about the physical health of our patients is not being communicated effectively with other care providers. This in turn can prevent patients being offered interventions needed to improve their cardiovascular health.Identifying this shortcoming in the transfer of information will allow us to educate the staff in our organisation and ensure that all the necessary physical health details will be included in future discharge documents. The result being improved outcomes and longer life expectancy of patients with serious mental illnesses, satisfying the purpose of the Lester Tool.

scholarly journals Completed Audit of Physical Health Status of Patients with Severe Mental Illness in a Medium Secure Forensic Psychiatric Rehab Ward

2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1
Author(s):  
M. George ◽  
P. Thakkar ◽  
K. Vasudev ◽  
N. Mitcheson
Keyword(s):  
Health Status ◽  
Physical Health ◽  
Health Monitoring ◽  
Smoking Status ◽  
Physical Health Status ◽  
Medication Regimen ◽  
National Guidelines ◽  
Blood Lipid Profile ◽  
Cholesterol Ratio ◽  
Image Position

Aim:An audit was conducted in September 2006 to determine whether the Physical health monitoring of patients on anti-psychotic medication was concurrent with the national guidelines.This audit done in Dec 07 aimed to ascertain to what extent the recommendations were implemented and followed, thereby completing the audit cycle.Methods:The Audit was conducted in a 15 bedded medium secure forensic rehab ward.As there was a lack of recording of the physical health status a monitoring sheet was introduced in the notes after the first audit. Age, Weight, Height, Smoking status, Blood Pressure, Diabetic Status, Blood Lipid Profile, ECG and the Medication regimen were noted for each of the patient.Results:Conclusion:100% physical health monitoring was achieved and improvements in weight, CV risk, Total/HDL cholesterol ratio was noted 4 cases of significant QT prolongation and another 3 cases of prolactin elevation were detected because of the introduction of monitoring.

scholarly journals The importance of the socioeconomic status of countries for mental disorders in old age: development of an epidemiological transition model

2007 ◽  
Vol 19 (4) ◽  
pp. 785-787 ◽  
Author(s):  
AJIT SHAH
Keyword(s):  
Socioeconomic Status ◽  
Life Expectancy ◽  
Old Age ◽  
Child Mortality ◽  
Univariate Analysis ◽  
Healthcare Services ◽  
Mortality Rates ◽  
Mental Illnesses ◽  
Per Capita Gdp ◽  
Per Capita

The prevalence of a disorder is a function of the incidence of the disorder and the duration of the illness (which may remit spontaneously, by treatment or death). The socioeconomic status of societies may influence the incidence and duration of mental illnesses in old age by influencing life expectancy and availability of appropriate healthcare services and treatments (Suh and Shah, 2001). The relationship between a proxy measure of the socioeconomic status (per capita gross national domestic product (GDP)) and (i) the life expectancy, (ii) child mortality rates and (iii) proxy measures of the quality and quantity of available healthcare services (the proportion of GDP spent on health, per capita expenditure on health and child mortality rates) was examined. The WHO website (www.who.int/countries/en/) provided data on these variables for 191 of the 192 countries for the year 2002. The inter-correlations between all the measured variables were examined using Pearson's correlation coefficient. Because of highly significant inter-correlations between all these variables, multiple linear regression analysis, with the Enter method, was undertaken with per capita GDP as the dependent variable, and all the variables that were significantly correlated with per capita GDP on univariate analysis as the independent variables.

scholarly journals A Scoping Review of Health Literacy Measurement Tools in the Context of Cardiovascular Health

2019 ◽  
Vol 46 (4) ◽  
pp. 677-688 ◽  
Author(s):  
Rita Wai Yu Chan ◽  
Adnan Kisa
Keyword(s):  
Health Literacy ◽  
Scoping Review ◽  
Cardiovascular Health ◽  
Measurement Tool ◽  
Care Providers ◽  
Valid Measurement ◽  
Broad Concept ◽  
Measurement Tools ◽  
Health Literacy Measurement ◽  
Print Literacy

Background. Despite the strong link between health literacy and cardiovascular health outcomes, health literacy measurements remain flawed and fragmented. There exists a gap in the knowledge when formulating a valid measurement to capture the broad concept of health literacy. The existence of various tools for health literacy measurement also hampers the availability of health literacy data. Additionally, little research is available on a valid measurement tool for cardiovascular health literacy. Objective. This study aims to provide an overview of the health literacy measurement tools used in the context of cardiovascular health. Method. A scoping review was conducted. Two electronic databases, Medline and Embase, were searched to identify studies that described a tool for the measurement of health literacy in the context of cardiovascular health. Results. After reviewing the available studies, 53 studies met the inclusion criteria. A total of 26 health literacy measurement tools were identified in the studies. Among the 26 tools, 16 used an objective measurement approach, 9 adopted a subjective approach, and 1 employed a mixed approach. Additionally, 28 studies used tools to measure print literacy, 15 studies measured print literacy and numeracy, and 5 studies measured print literacy, oral literacy, and numeracy. Conclusions. STOFHLA, TOFHLA, and REALM were the mostly commonly used tools in the selected studies. The majority of tools were based heavily on reading skills and word recognition. Researchers should focus on the development of more comprehensive and reliable health literacy measurement tool(s) specific to cardiovascular health to assist health care providers to more efficiently and accurately identify people with cardiovascular problems who have inadequate health literacy.

scholarly journals A syndemic of psychiatric morbidity, substance misuse, violence, and poor physical health among young men with reduced life expectancy

2021 ◽  
pp. 100858
Author(s):  
Jeremy Coid ◽  
Yingzhe Zhang ◽  
Paul Bebbington ◽  
Simone Ullrich ◽  
Bianca de Stavola ◽  
...  
Keyword(s):  
Life Expectancy ◽  
Physical Health ◽  
Substance Misuse ◽  
Psychiatric Morbidity ◽  
Young Men ◽  
Poor Physical Health

scholarly journals An Unsupervised Behavioral Modeling and Alerting System Based on Passive Sensing for Elderly Care

2020 ◽  
Vol 13 (1) ◽  
pp. 6
Author(s):  
Rui Hu ◽  
Bruno Michel ◽  
Dario Russo ◽  
Niccolò Mora ◽  
Guido Matrella ◽  
...  
Keyword(s):  
Health Status ◽  
Healthcare Service ◽  
Behavioral Science ◽  
Elderly Care ◽  
Elderly Person ◽  
Real Life ◽  
Healthcare Services ◽  
Living Condition ◽  
Care Providers ◽  
Remote Healthcare

Artificial Intelligence in combination with the Internet of Medical Things enables remote healthcare services through networks of environmental and/or personal sensors. We present a remote healthcare service system which collects real-life data through an environmental sensor package, including binary motion, contact, pressure, and proximity sensors, installed at households of elderly people. Its aim is to keep the caregivers informed of subjects’ health-status progressive trajectory, and alert them of health-related anomalies to enable objective on-demand healthcare service delivery at scale. The system was deployed in 19 households inhabited by an elderly person with post-stroke condition in the Emilia–Romagna region in Italy, with maximal and median observation durations of 98 and 55 weeks. Among these households, 17 were multi-occupancy residences, while the other 2 housed elderly patients living alone. Subjects’ daily behavioral diaries were extracted and registered from raw sensor signals, using rule-based data pre-processing and unsupervised algorithms. Personal behavioral habits were identified and compared to typical patterns reported in behavioral science, as a quality-of-life indicator. We consider the activity patterns extracted across all users as a dictionary, and represent each patient’s behavior as a ‘Bag of Words’, based on which patients can be categorized into sub-groups for precision cohort treatment. Longitudinal trends of the behavioral progressive trajectory and sudden abnormalities of a patient were detected and reported to care providers. Due to the sparse sensor setting and the multi-occupancy living condition, the sleep profile was used as the main indicator in our system. Experimental results demonstrate the ability to report on subjects’ daily activity pattern in terms of sleep, outing, visiting, and health-status trajectories, as well as predicting/detecting 75% hospitalization sessions up to 11 days in advance. 65% of the alerts were confirmed to be semantically meaningful by the users. Furthermore, reduced social interaction (outing and visiting), and lower sleep quality could be observed during the COVID-19 lockdown period across the cohort.

Umowy o udzielanie świadczeń opieki zdrowotnej zawierane przez Narodowy Fundusz Zdrowia (leczenie w ramach ubezpieczenia zdrowotnego) a leczenie na zasadach komercyjnych. Implikacje prawne i praktyczne

2021 ◽  
pp. 141-151
Author(s):  
Paweł Lipowski
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
Health Care Providers ◽  
Health Care Services ◽  
Legal Status ◽  
Healthcare Services ◽  
Care Providers ◽  
Care Services ◽  
Public Payer ◽  
Universal Health

The aim of this study is to identify the legal characteristics of contracts for the health care services provided by a public payer, i.e. the National Health Fund (NFZ) as part of treatment covered by universal health insurance, as compared to those provided by the health care providers with public or private legal status. This issue is discussed in relation to the legal conditions for the treatment of patients on a commercial basis in those institutions (private or public) which have contracts for the provision of healthcare services under the general health insurance (so-called contracts). The discussion is presented based on author’s own observations, resulting both from his scientific studies in the field of medical law and his work in various entities operating in the health care system.

scholarly journals Understanding barriers to accessing mental health services for newcomers to Canada using Peterborough, Ontario, as an illustrative example

2021 ◽  
Author(s):  
Nurun Layla Chowdhury
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Help Seeking ◽  
Mental Healthcare ◽  
Healthcare Services ◽  
Mental Illnesses ◽  
Cultural Barriers ◽  
Accurate Information

The quality of an individual’s mental health has a significant impact on their quality of life, as well as on the cost to society. Regular access to mental health services can help mitigate the risk factors of developing mental illnesses. This paper examines barriers to accessing mental health services, using the community of Peterborough, Ontario, as an example. Social, economic, and cultural barriers impact help-seeking amongst immigrants, putting them at a higher risk of developing mental disorders. The social determinants of mental health can be useful when developing policies aimed at improving utilization of mental healthcare services. Policy makers need to first focus on collecting accurate information on the population, and then developing targeted solutions to eliminate barriers such as language and employment that prevent help-seeking in immigrants.

scholarly journals Audit of inpatient smoking cessation advice

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S92-S93
Author(s):  
Flensham Mohamed ◽  
Mohamed Bader
Keyword(s):  
Smoking Cessation ◽  
Risk Factor ◽  
Physical Health ◽  
Replacement Therapy ◽  
Nicotine Replacement Therapy ◽  
Smoking Status ◽  
Health Board ◽  
List Type ◽  
Nicotine Replacement ◽  
Smoking Cessation Advice

AimsAudit carried out to assess whether or not patients had been asked about their smoking status during admission onto an acute adult mental health ward, as well as if they had received any smoking cessation advice or offered nicotine replacement therapy.Background•Physical health outcomes in patients with serious mental illness (SMI) are consisitently worse than the general public This is due to multiple factors; adverse effects of medication (including metabolic syndromes with psychotropics) as well as poor lifestyle factors such as smoking status•Patients with an SMI are 3–6 times more likely to die due to coronary artery disease. 70% of patients in inpatient psychiatric units are smokers, a strong independent risk factor for cardiovascular disease.•Smoking cessation is a potent modifiable risk factor that can prevent mortality and reduce morbidity.MethodA cross-sectional review of all 34 inpatients across four general adult acute psychiatric wards.Patient records were explored using the Aneuran Bevan Health Board admission proformas to identify evidence of smoking status and whether advice was offered.ResultSmoker but not given cessation advice n = 13 (38%)Not asked about smoking n = 11 (32%)Smoker and given cessation advice n = 4 (12%)Non-smoker n = 6 (18%)ConclusionPatients were asked about their smoking status the majority of the time (68%) but provision of advice or nicotine replacement therapy was only done in 14% of potential smokers (identified smokers and patients not asked about smoking status).A consideration to be taken into account is that on admission, a patient's physical health status may be unknown, with the additional difficulty of a patient's acute distress complicating the physical examination, smoking status and modification of patient's smoking status may not be the highest priory in that context.Data regarding asking about smoking were different amongst wards, potentially signifying differences between assessors willingness to ask about smoking status.There is a lack of smoking cessation literature available on the wards and patients are often unaware of what options are available to quit smoking.The audit simply determined whether or not assessors were documenting smoking status, it does not measure the quantity or quality of smoking cessation advice provided.Further quality improvement projects should be launched, with focus groups as the intial step at further investigating inpatient smoking rates, as well as attempting to reduce them in a more systemic way.

scholarly journals Cardiovascular Health Is Associated With Disability Among Older Community Dwelling Men and Women

2018 ◽  
Vol 31 (8) ◽  
pp. 1339-1352
Author(s):  
Yichen Jin ◽  
Toshiko Tanaka ◽  
Yan Ma ◽  
Stefania Bandinelli ◽  
Luigi Ferrucci ◽  
...  
Keyword(s):  
Activities Of Daily Living ◽  
Daily Living ◽  
Cardiovascular Health ◽  
Smoking Status ◽  
Plasma Cholesterol ◽  
Fasting Blood Glucose ◽  
Community Dwelling ◽  
Older Individuals ◽  
Cox Models ◽  
Point Increase

Objective: The aim of this study was to investigate whether an index of overall cardiovascular health (CVH) is associated with disability in older individuals. Method: Data on 925 participants of the InCHIANTI study (Invecchiare in Chianti, aging in the Chianti area, ≥65 years, 55% women) with median follow-up of 9 years were used. CVH score was assessed by smoking status, physical activity, body mass index, diet quality, blood pressure, plasma cholesterol, and fasting blood glucose. Disability was examined using instrumental activities of daily living (IADL disabilities >0 vs. 0) and activities of daily living (ADL disabilities >0 vs. 0). Generalized estimating equations and Cox models assessed relationships between baseline CVH with disability and worsening over 9 years. Results: A 1-point increase in the CVH score was associated with 23% and 17% of lower odds of ADL ( p < .001) and IADL ( p < .001) disability and was protective of worsening of disability over 9 years. Cox models demonstrated that a 1-point increase in CVH score was associated with lower hazards of both ADL (hazard ratio [HR] = 0.86, p = .005) and IADL (HR = 0.91, p = .007) disability. Discussion: Among older individuals, better CVH was associated with lower risk of disability and worsening over 9 years.

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