scholarly journals “Beth”: the development of a digital personalised health record and patient portal for use in clinical practice

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S188-S188
Author(s):  
George Gillett ◽  
Barbara Arroyo ◽  
The Beth Team
Keyword(s):  
Patient Safety ◽  
Clinical Practice ◽  
Text Messages ◽  
Self Management ◽  
Health Record ◽  
Patient Portal ◽  
Clinical Assessments ◽  
Care Plans ◽  
Measurement Based Care ◽  
Telephone Calls

AimsTo design & develop a clinically scalable personalised health record and patient portal to;Improve patient safety through improved communication and information sharing between staff, patients and carers, and improved access to safety plans for patients.Increase the uptake of virtual appointments and video calls rather than over-reliance on telephone calls for clinical careEmpower patients to access supported self-management and self-directed care using digital resourcesBackgroundCurrent mental health services often rely on telephone calls, letters, text messages and email, which often repeat information to the detriment of the patient. Likewise, care plans and appointments are given in paper cards, which can be lost or become out-dated. Furthermore, service-users often have no access to curated resources, symptom-tracking tools or ability to document their personal treatment targets in medical notes.MethodBased on service-user feedback, clinical need and the above aims, a digital personalised health record and online portal was developed for patients to record personal goals & coping strategies, access crisis plans, view appointments, track symptoms, complete clinical assessments, communicate with their care-team and access self-management materials. The tool, ‘Beth’, was named after the Bethlem Royal Hospital and was launched in July 2020 to all patients in the South London and Maudsley Trust.ResultAcross the Trust, the tool currently has 710 active users. Features used include; accessing care plans and safety plans, communicating with care teams, organising and viewing appointments, undertaking clinical assessments to inform measurement-based care, tracking symptoms and progress, developing a secure diary, and accessing free & trusted self-management resources.ConclusionWe have developed “Beth,” a digital personalised health record and patient portal for use in widespread clinical practice. The tool allows patients to take an active role in their care-planning, enhances communication between patients, carers and clinical teams and may improve service efficiency and patient safety. Future development may customise the tool further to incorporate new features and optimise usability for patients and clinicians alike.

A Preliminary Audit of Interruptions in Intensive Care: Implications for Patient Safety

2008 ◽  
Vol 9 (3) ◽  
pp. 240-242 ◽  
Author(s):  
Graham R Nimmo ◽  
Claire Mitchell
Keyword(s):  
Patient Safety ◽  
Intensive Care ◽  
Clinical Practice ◽  
Educational Interventions ◽  
Text Messages ◽  
Face To Face ◽  
Telephone Calls ◽  
Ward Rounds

Interruptions occur throughout clinical practice. They occur during ward rounds, procedures, discussions with relatives or specialists, while checking drugs or equipment, when prescribing and writing in notes. They can take the form of face-to-face interaction, telephone calls or text messages, pagers, alarms on monitors or equipment. They may be for mundane reasons, low priority or urgent. They may be for relaying information, to refer patients, to discuss plans, to arrange treatment or investigations. Some are unnecessary and potentially unsafe, but others are essential re-directions to more urgent clinical situations. It may be that educational interventions could be used to reduce the detrimental effects of ill-timed interruptions and to promote effective re-directional interruptions.

Using a mobile app to enhance the uptake of survivorship care plans (SCP) for adolescent and young adult survivors of childhood cancer.

2017 ◽  
Vol 35 (5_suppl) ◽  
pp. 74-74
Author(s):  
Lisa Schwartz ◽  
Dava Szalda ◽  
Alexandra M Psihogios ◽  
Elizabeth Shea Ver Hoeve ◽  
Lauren Daniel ◽  
...  
Keyword(s):  
Childhood Cancer ◽  
Mobile App ◽  
Text Messages ◽  
Adolescent And Young Adult ◽  
Care Plan ◽  
Self Management ◽  
Survivorship Care Plan ◽  
Survivorship Care Plans ◽  
Survivorship Care ◽  
Care Plans

74 Background: Survivorship self-management, including adherence to survivorship care plans (SCPs), is variable, especially among adolescents and young adults (AYA). Methods:The present study describes the development of a mobile application (app) for AYA survivors (AYA STEPS), which strives to improve survivorship self-management via a combined texting self-management program (THRIVE 2.0) and an electronic survivorship care plan generator (Smart-ALACC [Smart-Adult Living After Childhood Cancer], hosted on Oncolink.org). Results: AYA STEPS was developed by modifying an existing disease management app, LSTCare. The main feature of the app is the delivery of two-way text messages that are tailored to an individual’s SCP. The messages are designed to enhance uptake of the SCP with information, strategies for adherence, motivational messages, and appointment reminders. Patients may also text back with questions. The SCP and its related text information are customized based on input of patient characteristics and treatment history, such as age, time off treatment, and type of treatment (e.g., anthracycline chemotherapy, mediastinal radiation, cranial radiation). The app also houses a copy of the complete SCP document. The SCP is generated, via patient or provider, via an electronic platform that incorporates patient demographic information, cancer diagnosis, and cancer treatments received with checklist of options. Feedback on the app was provided by AYA ages 15 to 21 via a focus group (n = 5) and interviews (n = 5), through which qualitative data were collected. AYA reported high acceptability of a mHealth intervention to improve self-care as cancer survivors, especially the inclusion of tailored content from an individualized SCP as text messages. They also reported the app as feasible to download and maintain on their phones. Conclusions: We are about to begin a RCT that will test adherence to SCP for those who received the app and the SCP versus the SCP alone. We will report details of the app and the launch of the RCT. We expect high acceptability and feasibility with measured benefit to receiving the self-management app.

What Can Human Factors Contribute to Improve Electronic Health Record Usability and Patient Safety?

2012 ◽  
Author(s):  
Robert Schumacher ◽  
Robert North ◽  
Matthew Quinn ◽  
Emily S. Patterson ◽  
Laura G. Militello ◽  
...  
Keyword(s):  
Patient Safety ◽  
Human Factors ◽  
Electronic Health Record ◽  
Health Record ◽  
Electronic Health

Uji Validitas Dan Reliabilitas Kuesioner Pengukuran Kompetensi Sistem Informasi Keperawatan: NICAT Dalam Bahasa Indonesia

2019 ◽  
Vol 8 (1) ◽  
pp. 39-43
Author(s):  
Stephanie Dwi Guna ◽  
Yureya Nita
Keyword(s):  
Patient Safety ◽  
Electronic Health Record ◽  
Assessment Tool ◽  
Competency Assessment ◽  
Health Record ◽  
Nursing Informatics ◽  
Cronbach’S Alpha ◽  
Cronbach's Alpha ◽  
Electronic Health ◽  
Bahasa Indonesia

Integrasi Teknologi Informasi (TI) di bidang kesehatan terbukti meningkatkan kualitas pelayanan kesehatan dengan meningkatkan patient safety serta mempercepat waktu layanan. Salah satu inovasi TI di bidang kesehatan yaitu rekam medik elektronik (electronic health record). Rekam medik jenis ini sudah umum digunakan di negara maju namun masih jarang digunakan di negara berkembang termasuk Indonesia. Sebelum pengimplementasian suatu sistem informasi baru di pelayanan kesehatan, perlu dipastikan bahwa user dapat mengoperasikannya dengan baik sehingga hasil dari sistem tersebut optimal. Perawat sebagai tenaga kesehatan dengan jumlah paling banyak di suatu pelayanan kesehatan seperti Rumah Sakit merupakan user terbesar bila rekam medik elektronik ini diterapkan.  Oleh karena itu diperlukan suatu alat untuk mengukur kemampuan atau literasi sistem informasi keperawatan (SIK). Salah satu alat ukur kompetensi SIK yaitu NICAT (Nursing Informatics Competency Assessment Tool) yang memiliki 3 bagian serta 30 item pertanyaan. Penulis melakukan alih bahasa pada kuesioner ini, kemudian melakukan uji validitas dan reliabilitas. Jumlah sampel pada penelitian ini yaitu 233 perawat di salah satu Rumah Sakit Pemerintah di Pekanbaru, Indonesia. Hasil uji validitas pada 30 item dengan r tabel 0.128 menunjukkan r hitung diatas nilai tersebut dengan Cronbach’s Alpha 0,975. Dapat disimpulkan kuesioner pengukuran kemampuan SIK (NICAT versi Bahasa Indonesia) telah valid dan reliabel sehingga dapat digunakan mengukur kemampuan SIK perawat Indonesia.

Using a Patient Portal to Expand Warfarin Self-Management

2020 ◽  
Author(s):  
Amanda Cabral ◽  
Kathleen R. Bonaventura ◽  
Kerry A. Milner
Keyword(s):  
Self Management ◽  
Patient Portal

scholarly journals Risks in Management of Enteral Nutrition in Intensive Care Units: A Literature Review and Narrative Synthesis

Nutrients ◽  
2020 ◽  
Vol 13 (1) ◽  
pp. 82
Author(s):  
Magdalena Hoffmann ◽  
Christine Maria Schwarz ◽  
Stefan Fürst ◽  
Christina Starchl ◽  
Elisabeth Lobmeyr ◽  
...  
Keyword(s):  
Patient Safety ◽  
Intensive Care ◽  
Clinical Practice ◽  
Literature Review ◽  
Enteral Nutrition ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Rapid Review ◽  
Narrative Synthesis ◽  
Safety Issues

Critically ill patients in the intensive care unit (ICU) have a high risk of developing malnutrition, and this is associated with poorer clinical outcomes. In clinical practice, nutrition, including enteral nutrition (EN), is often not prioritized. Resulting from this, risks and safety issues for patients and healthcare professionals can emerge. The aim of this literature review, inspired by the Rapid Review Guidebook by Dobbins, 2017, was to identify risks and safety issues for patient safety in the management of EN in critically ill patients in the ICU. Three databases were used to identify studies between 2009 and 2020. We assessed 3495 studies for eligibility and included 62 in our narrative synthesis. Several risks and problems were identified: No use of clinical assessment or screening nutrition assessment, inadequate tube management, missing energy target, missing a nutritionist, bad hygiene and handling, wrong time management and speed, nutritional interruptions, wrong body position, gastrointestinal complication and infections, missing or not using guidelines, understaffing, and lack of education. Raising awareness of these risks is a central aspect in patient safety in ICU. Clinical experts can use a checklist with 12 identified top risks and the recommendations drawn up to carry out their own risk analysis in clinical practice.

scholarly journals Use of prescribing safety quality improvement reports in UK general practices: a qualitative assessment

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Nada F. Khan ◽  
Helen P. Booth ◽  
Puja Myles ◽  
David Mullett ◽  
Arlene Gallagher ◽  
...  
Keyword(s):  
Patient Safety ◽  
Quality Improvement ◽  
Clinical Practice ◽  
General Practitioners ◽  
Qualitative Assessment ◽  
Practice Research ◽  
Clinical Practice Research Datalink ◽  
Case Review ◽  
Local Networks ◽  
Quality Culture

Abstract Background Quality improvement (QI) initiatives are increasingly used to improve the quality of care and reduce prescribing errors. The Royal College of General Practitioners (RCGP) and Clinical Practice Research Datalink (CPRD) QI initiative uses routinely collected electronic primary care data to provide bespoke practice-level reports on prescribing safety. The aim of this study was to explore how the QI reports were used, barriers and facilitators to use, long-term culture change and perceived impact on patient care and practices systems as a result of receiving the reports. Methods A qualitative study using purposive sampling of practices contributing to the CPRD, semi-structured interviews and inductive thematic analysis. We interviewed general practitioners, pharmacists, practice managers and research nurses. Results We conducted 18 interviews, and organised themes summarising the use of QI reports in practice: receiving the report, facilitators and barriers to acting upon the reports, acting upon the report, and how the reports contribute to a quality culture. Effective dissemination of reports, and a positive attitude to audit and the perceived relevance of the clinical topic facilitated use. Lack of time and failure to see or act upon the reports meant they were not used. Factors influencing use of the reports included the structure of the report, ease of identifying cases, and perceptions about coding accuracy. GPs and pharmacists used the reports to conduct case reviews and directly contact patients to discuss unsafe prescribing and patient medication preferences. Finally, the reports contributed to the development of a quality culture within practices through promoting audit activity and acting as a reminder of good prescribing behaviours, promoting future patient safety initiatives, contributing to continuing professional development and improving local networks. Conclusions This study found the reports facilitated individual case review leading to an enhanced sense of quality culture in practices where they were utilised. Our findings demonstrate that the reports were generally considered useful and have been used to support patient safety and clinical practice in specific cases.

Type 2 diabetes self-management: spirituality, coping and responsibility

2021 ◽  
Vol 26 (8) ◽  
pp. 743-760
Author(s):  
Natasha Duke
Keyword(s):  
Type 2 Diabetes ◽  
Health Beliefs ◽  
Diabetes Management ◽  
Coping Styles ◽  
Glycated Haemoglobin ◽  
Self Management ◽  
Living Situation ◽  
Care Plans ◽  
Interpretive Method

Background In England, although The National Institute of Health and Care Excellence recommends that patients’ religious beliefs should be incorporated into individual healthcare plans, these components are often neglected in diabetes management care plans. A literature review identified a paucity of research regarding how the spirituality of British people may influence their approach to their self-management of type 2 diabetes (T2D). Aims To explore how the spirituality of a small group of adults with T2D, living in England, influenced their coping strategies and self-management of diet and exercise. Methods Biographic Narrative Interpretive Method of two interviews per participant and thematic analysis for data interrogation ( n = 8). Data as glycated haemoglobin, living situation, age, length of time since T2D diagnosis, body mass index and diabetic medicines contextualised the interview data. Results Participants’ spirituality, health beliefs, coping and sense of responsibility for T2D self-management overlapped in complex layers. Three themes were generated: (a) spirituality influences expectations in life; (b) beliefs influence coping styles of diabetes self-management; and (c) responsibility influences diabetes self-management. A model was created to assist nurses in addressing these components. Conclusion Nurses should consider how patients’ self-management of T2D may be influenced by their spirituality, health beliefs, coping and sense of responsibility.

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