scholarly journals Novel outpatient management of mild to moderate COVID-19 spares hospital capacity and safeguards patient outcome: The Geneva PneumoCoV-Ambu study

PLoS ONE ◽  
2021 ◽  
Vol 16 (3) ◽  
pp. e0247774
Author(s):  
Chloé Chevallier Lugon ◽  
Mikaela Smit ◽  
Julien Salamun ◽  
Meriem Abderrahmane ◽  
Olivia Braillard ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
Health Care Systems ◽  
University Hospital ◽  
High Rate ◽  
Ordinal Scale ◽  
Outpatient Management ◽  
Hospital Capacity ◽  
Hospitalization Costs ◽  
Novel Coronavirus ◽  
The Impact

Background Severe Acute Respiratory Coronavirus 2 (SARS-CoV-2), the novel coronavirus that causes coronavirus disease (COVID-19), is creating an unprecedented burden on health care systems across the world due to its high rate of pneumonia-related hospitalizations. This study presents recommendations for the outpatient management of moderate SARS-CoV-2 pneumonia implemented at the Geneva University Hospital, Switzerland, from April 4 to June 30, 2020 and evaluated the impact of these recommendations on patient safety, patient satisfaction, and overall hospital capacity. Methods Recommendations for the outpatient management of moderate pneumonia implemented in the Geneva University Hospital (PneumoCoV-Ambu) between April 4 and June 30, 2020, were evaluated prospectively. The primary endpoint was hospitalization. Secondary endpoints were: severity of COVID-19 disease based on a 7-points ordinal scale assessed at 1 and 2 months following SARS-CoV-2 infection; patient satisfaction using a satisfaction survey and the analysis of number of beds and costs potentially averted. Results A total of 36 patients with COVID-19-related pneumonia were followed between April 4 and May 5, 2020. Five patients (14%) were hospitalized and none died over a median of 30 days follow-up. The majority of patients (n = 31; 86%) were satisfied with the ambulatory care they received. These novel recommendations for outpatient management resulted in sparing an estimated potential 124 hospital bed-nights and CHF 6’826 per capita averted hospitalization costs over the three months period. Conclusions Recommendations developed for the outpatient management of COVID-19-related pneumonia were able to spare hospital capacity without increasing adverse patient outcomes. Widely implementing such recommendations is crucial in preserving hospital capacity during this pandemic.

scholarly journals Treatment of Anorexia Nervosa: The Importance of Disease Progression in the Prognosis

2017 ◽  
Vol 30 (7-8) ◽  
pp. 517
Author(s):  
Rodrigo Andrade ◽  
Manuel Gonçalves-Pinho ◽  
António Roma-Torres ◽  
Isabel Brandão
Keyword(s):  
Anorexia Nervosa ◽  
Dropout Rate ◽  
University Hospital ◽  
High Rate ◽  
Prognostic Features ◽  
Illness Duration ◽  
Intense Fear ◽  
Life Threatening ◽  
Fear Of Weight Gain ◽  
The Impact

Introduction: Anorexia nervosa is a severe, usually chronic, life-threatening disease of complex etiology characterized by food restriction, overestimation of the importance of body weight and image, intense fear of weight gain and distortion of body image. Anorexia nervosa is associated with high rates of mortality, suicide and decreased quality of life. Our aim is to present an anorexia nervosa treatment program offered in a major university hospital in Portugal, and to determine the impact of illness duration before admission on the outcome. Our hypothesis is that patients with greater disease longevity may have worse prognosis and poorer outcome.Material and Methods: The sample included data from case records of 169 patients seen consecutively and for the first time at Centro Hospitalar São João, between 2010 and 2015. We performed a retrospective observational study which included data collected at admission and from later follow-up years.Results: From the initially selected patients, 14.8% reached total remission, 16% accomplished partial remission and 14.2% ended up with exacerbation/stagnation of the disease. The dropout rate was of 55% throughout our study period. We found significant differences on outcome rates between distinct illness duration groups (p = 0.007).Discussion: There are several factors frequently associated with poor outcome for anorexia nervosa. The interpretation of outcome findings was limited by the high rate of dropout and lack of consistent definition criteria.Conclusion: Our results support the idea that illness duration has an important role on the outcome and prognostic features of these patients.

Perceptions of nurses on the impact of accreditation on quality of care

2014 ◽  
Vol 19 (2) ◽  
pp. 69-82 ◽  
Author(s):  
Ahmet Yildiz ◽  
Sidika Kaya
Keyword(s):  
Regression Analysis ◽  
Patient Satisfaction ◽  
Quality Of Care ◽  
Positive Impact ◽  
Pearson Correlation ◽  
High Rate ◽  
Content Type ◽  
Independent Variables ◽  
The Impact

Purpose – This article aims to investigate perceptions of Turkish nurses on the impact of accreditation on quality of care and the effect of accreditation on quality results. Design/methodology/approach – This study was performed as a cross-sectional, questionnaire-based survey on 258 nurses who started working in the hospital before it was accredited and continued to work during and after accrediation and who therefore knew both the hospital's pre-accrediation and post-accreditation periods. In this study, descriptive statistical analyses (means and standard deviations) were carried out to explore the views of the participants on “quality results,” “benefits of accreditation” and “participation of employees.” “Quality results” was considered to be the dependent variable, while “benefits of accreditation” and “participation of employees” were accepted as the independent variables. The relationship between the dependent variable and the independent variables was tested using Pearson correlation and multiple regression analysis. External patient satisfaction data collected by the quality department of the hospital before and after accreditation were also investigated. Findings – It was found that nurses had generally high scores for the items concerning the benefits of accreditation. There was a statistically significant positive correlation between the dependent variable (quality results) and the independent variables (benefits of accreditation and participation of employees). Regression analysis indicated that R2=0.461 and the extent to which the independent variables explained the dependent variable was 46.1 per cent, which is a high rate. Patient satisfaction scores increased after accreditation. Practical implications – Our study suggest that providing support for nurses, especially nurses with administrative responsibilities and incorporating employees into the process are important for exercising quality standards. Originality/value – Hospital accreditation has a positive impact on quality results especially on quality of care provided to patients and patient satisfaction. Study findings could guide policy makers and hospital managers in Turkey and in other countries who are preparing or implementing accreditation.

scholarly journals P070 THE IMPACT OF THE COVID 19 PANDEMY ON HERNIA SURGERY IN UNIVERSITY HOSPITAL IN CZECH REPUBLIC

2021 ◽  
Vol 108 (Supplement_8) ◽  
Author(s):  
Barbora Jíšová ◽  
Jakub Woleský ◽  
Barbora East
Keyword(s):  
Czech Republic ◽  
Health Care Systems ◽  
University Teaching ◽  
University Hospital ◽  
Hernia Surgery ◽  
Similar Time ◽  
Record System ◽  
Medical Record System ◽  
Care Systems ◽  
The Impact

Abstract Aim The SARS- CoV-2 pandemic has greatly affected health care systems worldwide, including the Czech Republic. However, the degree to which Covid-19 has impacted on hernia surgery is unknown. The aim of this study was to review the hernia surgery workload in a large university teaching hospital department. Material and Methods A computer based medical record system was used to identify all patients undergoing elective and emergency hernia repair of all types from March 1 to November 30, 2020 and for a similar time period in 2019 at the Motol University Hospital, Prague. Results 194 elective hernia operations were undertaken over the study period in 2020, a reduction from the 285 over a similar period in 2019. The number of emergency hernia operations in 2020 was 13 compared to 25 in 2019. Conclusions The SARS –CoV- 2 pandemic has reduced both the number of elective and emergency hernia operations in 2020 compared to 2019. Time will tell if the reduced elective workload will subsequently increase the emergency hernia workload during the recovery from the pandemic.

scholarly journals Efficiency of Text Message Contact on Medical Safety in Outpatient Surgery: Retrospective Study (Preprint)

2019 ◽  
Author(s):  
Jeremy Peuchot ◽  
Etienne Allard ◽  
Bertrand Dureuil ◽  
Benoit Veber ◽  
Vincent Compère
Keyword(s):  
Conversion Rate ◽  
Outpatient Surgery ◽  
University Hospital ◽  
Controlled Study ◽  
Full Time ◽  
Medical Safety ◽  
Hospitalization Costs ◽  
Sms Reminder ◽  
Sms Reminders ◽  
The Impact

BACKGROUND Establishing pre- and postoperative contact with patients is part of successful medical management in outpatient surgery. In France, this is mostly done via telephone. Automated information with short message service (SMS) reminders might be an interesting alternative to increase the rate of compliance with preoperative instructions, but no study has shown the safety of this approach. OBJECTIVE The objective of this study was to evaluate the impact of pre- and postoperative automated information with SMS reminders on medical safety in outpatient surgery. METHODS We conducted a retrospective, single-center, nonrandomized, controlled study with a before-after design. All adult patients who had outpatient surgery between September 2016 and December 2017 in our university hospital center were included. Before April 2017, patients were contacted by telephone by an outpatient surgery nurse. After April 2017, patients were contacted by SMS reminder. All patients were contacted the day before and the day after surgery. Patients contacted by SMS reminder were also contacted on day 7 after surgery. The primary end point was the conversion rate to full-time hospitalization. Secondary end points were hospitalization causes (anesthetic, surgical, organizational) and hospitalization costs. RESULTS A total of 4388 patients were included, 2160 before and 2228 after the introduction of SMS reminders. The conversion rate to full-time hospitalization was 34/4388 (0.77%) with a difference between SMS group (8/2228, 0.36%) and telephone group (26/2160, 1.20%). The cost of SMS reminders was estimated as half that of telephone calls. CONCLUSIONS In this work, we report a decrease in the rate of conversion to full-time hospitalization with the use of pre- and postoperative SMS reminders. This new approach could represent a safe and cost-effective method in an outpatient surgery setting.

scholarly journals The Impact of the lockdown on ENT services during the COVID-19 Pandemic, a report from the developing world.

2020 ◽  
Author(s):  
Kapila Hari ◽  
Shivesh Maharaj
Keyword(s):  
Health Care ◽  
Health Care Systems ◽  
Outpatient Clinics ◽  
Vulnerable Groups ◽  
The Novel ◽  
Phase 2 ◽  
Outpatient Procedures ◽  
Care Systems ◽  
Novel Coronavirus ◽  
The Impact

Abstract The novel coronavirus and accompanying lockdown measures have resulted in the disruption of specialist clinic services. There have been reports of a decrease in the number of clinic attendees and surgical procedures performed in clinics throughout the worldThe study period was from the 2 January 2020 until 19 June 2020 which was divided by the lockdown date of the 26 March 2020, into two periods of 85 days for comparative review.During the pre-lockdown phase (2 January 2020 to 25 March 2020), 2160 patients were booked for the outpatient clinics and 1911 attended in this period (88.5%). In contrast during the post-lockdown period (26 March 2020 to 19 June 2020), 1220 visits were scheduled. Of these, 937 (76.8%) visits were completed. The number of patient visits booked (p=0.01) and completed (0.0001) after lockdown declined significantly. The total number of outpatient procedures performed pre-lockdown was 1892 (0.99/ patient) compared to 937 (1.04/ patient) post-lockdown. This represents an approximate decrease of 50% in the number of procedures completed post-lockdown but the change in the number of procedures/ patient was not significant (p=0.4).During the pre-lockdown phase 228 theatre cases were completed, including 66 emergencies and post-lockdown there were 188 cases together with 48 emergencies. There were no elective cases post-lockdown. The study illustrates that even during a stringent lockdown period there is an ongoing need for specialist ENT services and health care systems need to be tailored to manage all patients such that care is not shifted away from vulnerable groups and solely focused on Covid19 patients.

Comparison of Head and Neck Cancer Distribution in Turkish and Syrian Populations

2020 ◽  
Author(s):  
Gozde SERİNDERE ◽  
Behiye BOLGUL ◽  
Didar GURSOY ◽  
Sibel HAKVERDİ ◽  
Nazan SAVAS
Keyword(s):  
Head And Neck ◽  
Turkish Population ◽  
Developed Countries ◽  
University Hospital ◽  
High Rate ◽  
Pathology Report ◽  
Increased Risk ◽  
Turkish Patients ◽  
Risk Of Cancer ◽  
The Impact

Background: Although oral health improves in several countries, global problems are still present. Predictably, the disadvantaged and poor population groups in both developing and developed countries have high rate of malign disease. The aim of this study was to evaluate the prevalence of head and neck cancers (HNCs) and to compare them between Syrian and Turkish population. Methods: A total of 4570 patients confirmed to have HNC histopathologically from Hatay Mustafa Kemal University Hospital Pathology report archive were retrospectively evaluated. Among them, 452 were Syrian patients while 4118 were Turkish patients. Data were collected from 2010 to 2017. Gender and age information were taken from medical records. According to the pathological results, HNCs were classified. Results: In 474 patients, HNCs were inscriptived, of which 317 were in males and 157 in females aged 23–80 years with histologically approved cancer of head and neck area. Overall, 100 were Syrian patients while 374 were Turkish patients. In both Syrian and Turkish patients, the most observed HNC was squamous cell carcinoma (SCC). Conclusion: Nowadays, the prevalence of cancer is higher because of the excessive consumption of alcohol, tobacco, chewing, and smoking. For the higher cancer incidence in Syrian refugees, we thought that the impact of war such as stress may have been effective as well as the known several etiologic factors of cancer. For the increased risk of cancer, the early diagnosis of this become more important.  

An early discharge approach for managing hospital capacity

2017 ◽  
Vol 08 (01) ◽  
pp. 1750006 ◽  
Author(s):  
Israa Mohamed ◽  
Ibrahim El-Henawy ◽  
Ramadan Zean El-Din
Keyword(s):  
Discrete Event ◽  
Real Data ◽  
Early Discharge ◽  
University Hospital ◽  
Limited Capacity ◽  
Hospital Capacity ◽  
Empirical Distributions ◽  
Event Simulation ◽  
The Impact ◽  
Des Model

The Kidney and Oncology Departments at Zagazig University Hospital are suffering from increased demand and limited capacity. Arrival patients who find all beds occupied are simply turned away, i.e., no waiting is allowed. This paper investigates the impact of an early discharge approach that can be applied to patients that have been scheduled to discharge within 5 h. A discrete event simulation (DES) model is built using empirical distributions based on real data. The model has been validated against real data and the results have shown that the proposed early discharge approach can reduce the number of turned away patients by 10% in the Kidney Department, equivalent to 182 patients annually and by 11% in the Oncology Department, equivalent to 150 patients annually.

scholarly journals The impact of armed conflict on the epidemiological situation of Coronavirus disease (COVID-19) in Libya, Syria, and Yemen

2021 ◽  
Author(s):  
Mohamed A Daw
Keyword(s):  
Armed Conflict ◽  
Early Stage ◽  
Significant Decline ◽  
Armed Conflicts ◽  
High Rate ◽  
Global Pandemic ◽  
Public Data ◽  
Novel Coronavirus ◽  
The Impact ◽  
International Strategies

BackgroundSince the Arab uprising 2011, Libya, Syria, and Yemen have gone through a major armed conflict. This resulted in a high rate of mortality, injury, and population displacement with a collapse of the health care system. Furthermore, it was complicated by the emergence of, COVID-19 as a global pandemic which made the population of these countries strive under unusual conditions to tackle both the pandemic and the ongoing wars. The objectives of this study were to determine the impacts and influence of armed conflicts on the epidemiology of Novel Coronavirus (SARS-CoV-2) within these war-torn countries and outline the needed strategies to combat the spread of the pandemic and its upcoming consequences.MethodsThe official and public data regarding the dynamics of armed conflict and the spread, of SARS-COV-19 in Libya, Syria, and Yemen were collected from all available sources. Starting from the early emergence of the COVID-19 in each country until the end of December 2020. Datasets were analyzed through a set of statistical techniques and the weekly resolved data were used to probe the link between the intensity levels of the armed conflict and the spread of the pandemic.ResultsData indicated that there is an increase in the intensity of violence levels at an early stage from March to August reached up to two folds in the three countries particularly in Libya. In this violent period, few cases of COVID-19 were reported ranging from 5-53 cases/day. From September to December, a significant decline in the level of the armed conflict was accompanied by steep upsurges in the number of reported COVID-19 cases reached up to 500 cases/day. The highest accumulative cases of COVID-19 were reported in Libya, Syria, and Yemen respectively.ConclusionsOur analysis demonstrates that the armed conflict has provided an opportunity for SARS-COV-19 to spread. At the early weeks of the pandemic that coincided with high levels of the armed conflict few cases were officially reported indicating a vast undercount, which may suggest a hidden mitigating spread at an early stage. Then the pandemic increased immensely as the armed conflict decline to reach the highest by December. A full-blown transmission of the COVID-19 pandemic in these countries is expected. Therefore, urgent national and international strategies should be implemented to combat the pandemic and its upcoming consequences.

scholarly journals What is required to prevent a second major outbreak of the novel coronavirus SARS-CoV-2 upon lifting the metropolitan-wide quarantine of Wuhan city, China

2020 ◽  
Author(s):  
Lei Zhang ◽  
Mingwang Shen ◽  
Xiaomeng Ma ◽  
Shu Su ◽  
Wenfeng Gong ◽  
...  
Keyword(s):  
High Rate ◽  
Chinese Government ◽  
The Novel ◽  
Wuhan City ◽  
Facial Mask ◽  
Staff Members ◽  
Contact Rates ◽  
Major Outbreak ◽  
Novel Coronavirus ◽  
The Impact

BackgroundThe Chinese government implemented a metropolitan-wide quarantine of Wuhan city on 23rd January 2020 to curb the epidemic of the coronavirus COVID-19. Lifting of this quarantine is imminent. We modelled the effects of two key health interventions on the epidemic when the quarantine is lifted.MethodWe constructed a compartmental dynamic model to forecast the trend of the COVID-19 epidemic at different quarantine lifting dates and investigated the impact of different rates of public contact and facial mask usage on the epidemic.ResultsWe estimated that at the end of the epidemic, a total of 65,572 (46,156-95,264) individuals would be infected by the virus, among which 16,144 (14,422-23,447, 24.6%) would be infected through public contacts, 45,795 (32,390-66,395, 69.7%) through household contact, 3,633 (2,344-5,865, 5.5%) through hospital contacts (including 783 (553-1,134) non-COVID-19 patients and 2,850 (1,801-4,981) medical staff members). A total of 3,262 (1,592-6,470) would die of COVID-19 related pneumonia in Wuhan. For an early lifting date (21st March), facial mask needed to be sustained at a relatively high rate (≥85%) if public contacts were to recover to 100% of the pre-quarantine level. In contrast, lifting the quarantine on 18th April allowed public person-to-person contact adjusted back to the pre-quarantine level with a substantially lower level of facial mask usage (75%). However, a low facial mask usage (<50%) combined with an increased public contact (>100%) would always lead a significant second outbreak in most quarantine lifting scenarios. Lifting the quarantine on 25th April would ensure a smooth decline of the epidemics regardless of the combinations of public contact rates and facial mask usage.ConclusionThe prevention of a second epidemic is viable after the metropolitan-wide quarantine is lifted but requires a sustaining high facial mask usage and a low public contact rate.

Exploring the impact of staff absenteeism on patient satisfaction using routine databases in a university hospital

2014 ◽  
Vol 23 (7) ◽  
pp. 833-841 ◽  
Author(s):  
E. Duclay ◽  
J.B. Hardouin ◽  
V. Sébille ◽  
E. Anthoine ◽  
L. Moret
Keyword(s):  
Patient Satisfaction ◽  
University Hospital ◽  
The Impact
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