scholarly journals Patients repeatedly attending accident and emergency departments seeking psychiatric care

2011 ◽  
Vol 35 (2) ◽  
pp. 60-62 ◽  
Author(s):  
Eugene F. Okorie ◽  
Colm McDonald ◽  
Brendan Dineen
Keyword(s):  
Chart Review ◽  
Psychiatric Care ◽  
Clinical Implications ◽  
Psychiatric Admissions ◽  
Accident And Emergency ◽  
Distinctive Group ◽  
Effective Community ◽  
Using Data ◽  
The Cost

Aims and methodThis study was conducted to ascertain the clinical characteristics of patients who repeatedly attend accident and emergency (A&E) department seeking psychiatric assessment and care. We identified 24 individuals who attended frequently and compared them with 72 matched single attenders using data abstracted by chart review.ResultsIndividuals who attended frequently made up 5.3% of all patients who attended the A&E department for psychiatric care but accounted for 19% of all such presentations. Compared with controls, they were younger at first psychiatric contact and had higher rates of schizophrenia and psychiatric admissions.Clinical implicationsA small but distinctive group of patients repeatedly seek and obtain hospital-based psychiatric care. Early identification of these patients and targeting them with effective, community-oriented strategies, such as home treatment, could improve their quality of life and prognoses as well as reduce the cost of their care.

scholarly journals Deliberate self-harm

2001 ◽  
Vol 25 (3) ◽  
pp. 98-101 ◽  
Author(s):  
Sean Whyte ◽  
Andrew Blewett
Keyword(s):  
Mental State ◽  
Psychiatric Care ◽  
Case Note ◽  
Clinical Implications ◽  
Deliberate Self Harm ◽  
Accident And Emergency ◽  
Self Harm ◽  
Medical Wards ◽  
The Impact

Aims and MethodA repetition after 5 years of a prospective case note audit, looking at the impact of a recently established deliberate self-harm (DSH) assessment team on the quality of DSH assessments at Kettering general hospital.ResultsAspecialist DSH team achieved improvement in the quality of psychiatric assessments for the majority of patients who harmed themselves. Assessments of mental state by accident and emergency (A & E) and medical staff before referral to the psychiatric team remain problematic.Clinical ImplicationsSetting up aspecialist team to assess patients who harm themselves can improve the quality of the psychiatric care they receive, but emphasis must still be placed on an adequate assessment of mental state by medical and nursing staff in A&E and on medical wards.

Home telehealth for chronic disease management: A systematic review and an analysis of economic evaluations

2009 ◽  
Vol 25 (03) ◽  
pp. 339-349 ◽  
Author(s):  
Julie Polisena ◽  
Doug Coyle ◽  
Kathryn Coyle ◽  
Sarah McGill
Keyword(s):  
Chronic Diseases ◽  
Current Evidence ◽  
Economic Evaluations ◽  
Future Studies ◽  
Provider Perspectives ◽  
Healthcare Decision Making ◽  
Home Telehealth ◽  
Using Data ◽  
The Cost

Objectives:The research objectives were two-fold: first, to systematically review the literature on the cost-effectiveness of home telehealth for chronic diseases, and second to develop a framework for the conduct of economic evaluation of home telehealth projects for patients with chronic diseases.Methods:A comprehensive literature search identified twenty-two studies (n= 4,871 patients) on home telehealth for chronic diseases published between 1998 and 2008. Studies were reviewed in terms of their methodological quality and their conclusions.Results:Home telehealth was found to be cost saving from the healthcare system and insurance provider perspectives in all but two studies, but the quality of the studies was generally low. An evaluative framework was developed which provides a basis to improve the quality of future studies to facilitate improved healthcare decision making, and an application of the framework is illustrated using data from an existing program evaluation of a home telehealth program.Conclusions:Current evidence suggests that home telehealth has the potential to reduce costs, but its impact from a societal perspective remains uncertain until higher quality studies become available.

An analysis of emergency leaves of absence from a United Kingdom high secure psychiatric hospital with a view to identifying ways to reduce their number

2017 ◽  
Vol 41 (S1) ◽  
pp. S354-S354
Author(s):  
H. Blott ◽  
C. Gordon ◽  
J. Bickford ◽  
C. Ross
Keyword(s):  
Physical Health ◽  
General Public ◽  
Psychiatric Care ◽  
Cost Effective ◽  
Potential Cost ◽  
Secure Psychiatric Care ◽  
The Cost ◽  
And Training ◽  
Do So

IntroductionEmergency leaves of absence (ELOAs) from high secure psychiatric care are both costly and increase the risk posed to staff, patients and the general public. ELOAs were analysed to identify whether greater on-site physical health provision could reduce their number, and quantify the potential financial saving to the trust to do so.MethodAll ELOAs from Broadmoor hospital between 15.5.15–14.11.15 were assessed by a team of psychiatrists and a GP to identify whether they were “avoidable”, “unavoidable” or “potentially avoidable” if measures were taken. For the “potentially avoidable” group, we then calculated the staffing cost of these LoAs to help ascertain whether these measures would be cost effective.ResultsThere were 30 ELOAs during the period assessed, costing £79,240 (Table 1). The table also shows which additional on-site services or training may have prevented these ELOAs, and the cost saving to the trust if they had.ConclusionsThe number of ELOAs from the hospital could be reduced by increased on-site physical health provision and training. This would improve the quality of care patients receive, as well as reducing both the cost to the trust and the risk posed to staff, patients and the general public. We must also consider the large potential cost and risks associated with a patient absconding from an ELOA.

Relating plaice (Pleuronectes platessa) recruitment to deteriorating habitat quality: effects of macroalgal blooms in coastal nursery grounds

2005 ◽  
Vol 62 (5) ◽  
pp. 1184-1193 ◽  
Author(s):  
Leif Pihl ◽  
Johan Modin ◽  
Håkan Wennhage
Keyword(s):  
Cost Benefit ◽  
Pleuronectes Platessa ◽  
Macroalgal Blooms ◽  
Management Actions ◽  
Nursery Habitats ◽  
Negative Effect ◽  
Using Data ◽  
The Cost ◽  
Algal Distribution

Concentration of juveniles of marine fishes in nurseries may act as a bottleneck during the life cycle, where quantity and quality of nurseries determine population size. Macroalgal blooms have become a common phenomenon in eutrophic shallow waters worldwide, and matforming algae may now cover many essential nursery habitats. In this investigation, the aim was to assess the quantitative effect of algal mats on the recruitment of plaice (Pleuronectes platessa) from nurseries in the Swedish Skagerrak archipelago. A model was constructed using data on nursery size, settling density, and mortality of plaice combined with data on algal distribution. Recruitment of 0-group plaice from nurseries could be reduced by 30%–40% due to algae. The largest negative effect occurred during high settlement, reducing the important influence of strong year classes on stock size. The model predicted a reduction of juveniles due to algae of 45–46 × 106 individuals at high settlement. This amounts to 68% of the output at medium settlement and equals the amount of plaice produced during 5 years of low settlement. Up to 75% of the total reduction could occur in one quarter of the study area. With limiting resources, management actions should not be generally applied but rather be concentrated to optimize the cost-benefit of measures taken.

Applying the Swedish Performance Assessment Framework in practise: assessment of efficiency and quality of psychiatric care

2011 ◽  
Vol 38 (S 01) ◽  
Author(s):  
B Lindelius ◽  
E Björkenstam ◽  
C Dahlgren ◽  
R Ljung ◽  
C Stefansson
Keyword(s):  
Performance Assessment ◽  
Psychiatric Care ◽  
Assessment Framework

Feasibility and Clinical Implications of Remotely Guided Ultrasound Examinations

2020 ◽  
Vol 91 (7) ◽  
pp. 592-596
Author(s):  
Quinn Dufurrena ◽  
Kazi Imran Ullah ◽  
Erin Taub ◽  
Connor Leszczuk ◽  
Sahar Ahmad
Keyword(s):  
Clinical Utility ◽  
Regional Wall Motion ◽  
Subjective Assessment ◽  
Clinical Implications ◽  
Pilot Studies ◽  
Objective Quality ◽  
The Us ◽  
Regional Wall Motion Abnormalities ◽  
Wall Motion Abnormalities

BACKGROUND: Remotely guided ultrasound (US) examinations carried out by nonmedical personnel (novices) have been shown to produce clinically useful examinations, at least in small pilot studies. Comparison of the quality of such exams to those carried out by trained medical professionals is lacking in the literature. This study compared the objective quality and clinical utility of cardiac and pulmonary US examinations carried out by novices and trained physicians.METHODS: Cardiac and pulmonary US examinations were carried out by novices under remote guidance by an US expert and independently by US trained physicians. Exams were blindly evaluated by US experts for both a task-based objective score as well as a subjective assessment of clinical utility.RESULTS: Participating in the study were 16 novices and 9 physicians. Novices took longer to complete the US exams (median 641.5 s vs. 256 s). For the objective component, novices scored higher in exams evaluating for pneumothorax (100% vs. 87.5%). For the subjective component, novices more often obtained clinically useful exams in the assessment of cardiac regional wall motion abnormalities (56.3% vs. 11.1%). No other comparisons yielded statistically significant differences between the two groups. Both groups had generally higher scores for pulmonary examinations compared to cardiac. There was variability in the quality of exams carried out by novices depending on their expert guide.CONCLUSION: Remotely guided novices are able to carry out cardiac and pulmonary US examinations with similar, if not better, technical proficiency and clinical utility as US trained physicians, though they take longer to do so.Dufurrena Q, Ullah KI, Taub E, Leszczuk C, Ahmad S. Feasibility and clinical implications of remotely guided ultrasound examinations. Aerosp Med Hum Perform. 2020; 91(7):592–596.

Effect of networks on product innovation: empirical evidence from Indonesian SMEs

2013 ◽  
Vol 1 (2) ◽  
pp. 140-158 ◽  
Author(s):  
Nurul Indarti ◽  
Theo Postma
Keyword(s):  
Empirical Evidence ◽  
Product Innovation ◽  
Dynamic Effects ◽  
Depth Of Knowledge ◽  
External Knowledge ◽  
Software Firms ◽  
Using Data

Innovative companies generally establish linkages with other actors and access external knowledge in order to benefit from the dynamic effects of interactive processes. Using data from 198 furniture and software firms in Indonesia, this study shows that the quality of interaction (i.e. multiplexity) as indicated by the depth of knowledge absorbed from various external parties and intensity of interaction (i.e., tie intensity) are better predictors of product innovation than the diversity of interaction.

Pengaruh Kompetensi Coder terhadap Keakuratan dan Ketepatan Pengkodean Menggunakan ICD 10 di Rumah Sakit X Pekanbaru Tahun 2016

2018 ◽  
Vol 1 (1) ◽  
pp. 31-43
Author(s):  
Nur Maimun ◽  
Jihan Natassa ◽  
Wen Via Trisna ◽  
Yeye Supriatin
Keyword(s):  
Medical Record ◽  
Human Error ◽  
Medical Personnel ◽  
Quality Of Data ◽  
Accuracy And Precision ◽  
Result Show ◽  
Study Implementation ◽  
Icd 10 ◽  
The Cost

The accuracy in administering the diagnosis code was the important matter for medical recorder, quality of data was the most important thing for health information management of medical recorder. This study aims to know the coder competency for accuracy and precision of using ICD 10 at X Hospital in Pekanbaru. This study was a qualitative method with case study implementation from five informan. The result show that medical personnel (doctor) have never received a training about coding, doctors writing that hard and difficult to read, failure for making diagnoses code or procedures, doctor used an usual abbreviations that are not standard, theres still an officer who are not understand about the nomenclature and mastering anatomy phatology, facilities and infrastructure were supported for accuracy and precision of the existing code. The errors of coding always happen because there is a human error. The accuracy and precision in coding very influence against the cost of INA CBGs, medical and the committee did most of the work in the case of severity level III, while medical record had a role in monitoring or evaluation of coding implementation. If there are resumes that is not clearly case mix team check file needed medical record the result the diagnoses or coding for conformity. Keywords: coder competency, accuracy and precision of coding, ICD 10

ABOUT NECESSITY OF MATHEMATICAL MODELING OF THE BUSINESS PROCESS OF COST ESTIMATE CALCULATIONS IN THE CONSTRUCTION OF OIL AND GAS FACILITIES

2017 ◽  
pp. 139-145
Author(s):  
R. I. Hamidullin ◽  
L. B. Senkevich
Keyword(s):  
Mathematical Modeling ◽  
Quality Assessment ◽  
Business Process ◽  
Oil And Gas ◽  
Oil And Gas Industry ◽  
Gas Industry ◽  
Construction Organizations ◽  
The Cost ◽  
Cost Of Construction

A study of the quality of the development of estimate documentation on the cost of construction at all stages of the implementation of large projects in the oil and gas industry is conducted. The main problems that arise in construction organizations are indicated. The analysis of the choice of the perfect methodology of mathematical modeling of the investigated business process for improving the activity of budget calculations, conducting quality assessment of estimates and criteria for automation of design estimates is performed.

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