Safety Evaluation of an Expedited Omalizumab Home Self-Administration Pathway (Preprint)

2021 ◽  
Author(s):  
Zobia Hussain
Keyword(s):  
Emergency Department ◽  
Northern Ireland ◽  
Clinical Data ◽  
Safety Evaluation ◽  
Standard Of Care ◽  
Clinic Attendance ◽  
Self Administration ◽  
Emergency Department Attendance ◽  
Face To Face

BACKGROUND The Northern Ireland Regional Immunology Service (NIRIS) has developed an expedited omalizumab home self-administration pathway to reduce face-to-face clinic attendance during the COVID19 pandemic. This audit evaluates the safety of this pathway with a particular focus on anaphylaxis. OBJECTIVE To retrospectively audit the records of 39 patient undertaking expedited home self-administration at NIRIS for complications, particularly Emergency Department attendance for anaphylaxis. The target was for 100% of patients to complete a six-month course without experiencing anaphylaxis related to omalizumab administration. METHODS 39 records of patients who underwent expedited omalizumab self-administration were audited by a single reviewer. They were prospectively collected between March 2020 and August 2021. Clinical data was collected from the Northern Ireland Electronic Care Record (NIECR). RESULTS 100% of patients were in the process of completing or had completed a six-dose course without anaphylaxis. 7.6% of patients attended the Emergency Department during their course of omalizumab. 0% experienced anaphylaxis triggered by omalizumab. The target of 100% patients completing the expedited pathway without omalizumab-related anaphylaxis was met. CONCLUSIONS The expedited omalizumab home self-administration pathway is safe and may become the standard of care post-pandemic.

Collection of Ego-Centered Network Data with Computer-Assisted Interviews

Methodology ◽  
2006 ◽  
Vol 2 (1) ◽  
pp. 7-15 ◽  
Author(s):  
Joachim Gerich ◽  
Roland Lehner
Keyword(s):  
Survey Methods ◽  
A Priori ◽  
Dynamic Structure ◽  
Computer Assisted ◽  
Network Data ◽  
Great Effort ◽  
Self Administration ◽  
Face To Face ◽  
Full Network

Although ego-centered network data provide information that is limited in various ways as compared with full network data, an ego-centered design can be used without the need for a priori and researcher-defined network borders. Moreover, ego-centered network data can be obtained with traditional survey methods. However, due to the dynamic structure of the questionnaires involved, a great effort is required on the part of either respondents (with self-administration) or interviewers (with face-to-face interviews). As an alternative, we will show the advantages of using CASI (computer-assisted self-administered interview) methods for the collection of ego-centered network data as applied in a study on the role of social networks in substance use among college students.

The Impact of COVID-19 on Emergency Department Attendance in a Vulnerable Population - The What, and the Why

2020 ◽  
Author(s):  
Rebecca L. Jessup ◽  
Cassandra Bramston ◽  
Alison Beauchamp ◽  
Anthony Gust ◽  
Natali Cvetanovska ◽  
...  
Keyword(s):  
Emergency Department ◽  
Vulnerable Population ◽  
Emergency Department Attendance ◽  
The Impact

scholarly journals Policy of free GP care for children under 6 years: the impact on Emergency Department attendance

2021 ◽  
pp. 113988
Author(s):  
Thérèse McDonnell ◽  
Eilish McAuliffe ◽  
Emma Nicholson ◽  
Michael Barrett ◽  
Gerard Bury ◽  
...  
Keyword(s):  
Emergency Department ◽  
Emergency Department Attendance ◽  
Gp Care ◽  
The Impact

scholarly journals 688 Rapid Implementation of Virtual Fracture Clinic During COVID 19 Reduces Both Face-To-Face Appointments and Facilitates Rapid Feedback and Education to Be Delivered to The Emergency Department

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
T Havenhand ◽  
L Hoggett ◽  
A Bhutta
Keyword(s):  
Emergency Department ◽  
Patient Flow ◽  
Prospective Data ◽  
Fracture Clinic ◽  
Face To Face ◽  
Return Rates ◽  
Acute Hospitals ◽  
Virtual Fracture Clinic ◽  
Improve Patient

Abstract Introduction COVID-19 has dictated a shift towards virtual clinics. Pennine Acute Hospitals NHS Trust serves over a million patients with a significant number of face-to-face fracture clinics. Introduction of a Virtual Fracture Clinic (VFC) reduces hospital return rates and improves patient experience. The referral data can be used to give immediate monthly feedback to the referring department to further improving patient flow. Method Prospective data was collected for all referrals to VFC during March 2020. Data included referral diagnosis, actual diagnosis, referrers grade, and final outcome. Results 630 referrals were made to VFC. 347 (55%) of those referrals were directly discharged without the need for physical consultation. Of these 114 (32%) were injuries which can be discharged by the Emergency Department with an advice leaflet using existing pathways. Of the remaining discharges 102 (29%) were query fractures or sprains; and 135 (39%) were minor fractures; which needed only advice via a letter and no face to face follow up. Conclusions Implementation of VFC leads to a decrease in physical appointments by 55% saving 347 face to face appointments. The new system has also facilitated effective audit of referrals in order to further improve patient flow from the Emergency Department via feedback mechanisms and education.

Foreign Body Ingestions in Children: Risk of Complication Varies With Site of Initial Health Care Contact

PEDIATRICS ◽  
1993 ◽  
Vol 91 (1) ◽  
pp. 121-127 ◽  
Author(s):  
Ronald I. Paul ◽  
Katherine Kaufer Christoffel ◽  
Helen J. Binns ◽  
David M. Jaffe ◽  
Keyword(s):  
Emergency Department ◽  
Foreign Body ◽  
Tertiary Care ◽  
Standard Of Care ◽  
Pediatric Emergency ◽  
Adverse Outcomes ◽  
Pediatric Emergency Department ◽  
Parent Supervision ◽  
Tertiary Care Hospitals ◽  
Patient Enrollment

Current recommendations for the management of pediatric foreign body ingestions are based on studies of patients cared for at tertiary care hospitals; they call for aggressive evaluation because of a high incidence of complications. Two hundred forty-four children with suspected foreign body ingestions were prospectively followed to analyze adverse outcomes, ie, procedures, complications, and hospitalizations. Patient enrollment into the study was from three sources: (1) patients who referred themselves to a tertiary pediatric emergency department, (2) patients referred to the same tertiary pediatric emergency department after an initial evaluation by another hospital or physician, and (3) Patients who reported their foreign body ingestions to a private pediatric practitioner participating in the study. Most children were well toddlers in normal circumstances, under parent supervision at the time of ingestion. Coins were the most common item ingested (46%). Procedures were done in 53 (24%) of 221 patients and complications occurred in 48 (22%) of 221. Complications were higher in patients referred to the emergency department (63%) than in emergency department self-referred patients (13%) or private practice patients (7%) (x2, P < .01). These findings demonstrate the risk of drawing conclusions regarding a universal standard of care from studies involving only hospital-based patients.

scholarly journals Cost Impact Model of a Novel Multi-mRNA Host Response Assay for Diagnosis and Risk Assessment of Acute Respiratory Tract Infections and Sepsis in the Emergency Department

2020 ◽  
Vol 7 (1) ◽  
pp. 24-34 ◽  
Author(s):  
John E. Schneider ◽  
Jonathan Romanowsky ◽  
Philipp Schuetz ◽  
Ivana Stojanovic ◽  
Henry K. Cheng ◽  
...  
Keyword(s):  
Emergency Department ◽  
Respiratory Tract ◽  
Host Response ◽  
Meta Analysis ◽  
Standard Of Care ◽  
Analysis Data ◽  
Disease Prevalence ◽  
Impact Model ◽  
Cost Impact ◽  
Tract Infections

Background: Early identification of acute infections and sepsis remains an unmet medical need. While early detection and initiation of treatment reduces mortality, inappropriate treatment leads to adverse events and the development of antimicrobial resistance. Current diagnostic and prognostic solutions, including procalcitonin, lack required accuracy. A novel blood-based host response test, HostDx™ Sepsis by Inflammatix, Inc., assesses the likelihood of a bacterial infection, the likelihood of a viral infection, and the severity of the condition. Objectives: We estimated the economic impact of adopting HostDx Sepsis testing among patients with suspected acute respiratory tract infection (ARTI) in the emergency department (ED). Methods: Our cost impact model estimated costs for adult ED patients with suspected ARTI under the standard of care versus with the adoption of HostDx Sepsis from the perspective of US payers. Included costs were those assumed to be associated with an episode of sepsis diagnosis, management, and treatment. Projected accuracies for test predictions, disease prevalence, and clinical parameters was derived from patient-level meta-analysis data of randomized trials, supplemented with published performance data for HostDx Sepsis. One-way sensitivity analysis was performed on key input parameters. Results: Compared to standard of care including procalcitonin, the superior test characteristics of HostDx Sepsis resulted in an average cost savings of approximately US$1974 per patient (-31.3%) exclusive of the cost of HostDx Sepsis. Reductions in hospital days (-0.80 days, -36.7%), antibiotic days (-1.49 days, -29.5%), and percent 30-day mortality (-1.67%, -13.64%) were driven by HostDx Sepsis providing fewer “noninformative” moderate risk predictions and more “certain” low- or high-risk predictions compared to standard of care, especially for patients who were not severely ill. These results were robust to changes in key parameters, including disease prevalence. Conclusions: Our model shows substantial savings associated with introduction of HostDx Sepsis among patients with ARTIs in EDs. These results need confirmation in interventional trials.

scholarly journals Peer mentoring in psychiatry: a trainee-led initiative

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S149-S149
Author(s):  
Zoe Moore ◽  
Linda Irwin ◽  
Stuart Brown ◽  
Julie Anderson ◽  
Stephen Moore
Keyword(s):  
Northern Ireland ◽  
Peer Mentoring ◽  
Training Session ◽  
Application Form ◽  
Face To Face ◽  
Mentoring Relationship ◽  
Educational Supervision ◽  
Video Calling ◽  
Psychiatry Trainee

AimsOur aim was to establish a Peer Mentoring Network within Psychiatry Training in Northern Ireland.Recognising that starting a new job can be a stressful time in any junior doctor's career, we wanted to ensure that new Core Trainees (CT1s) joining our Specialty Programme were well supported through this transition.Although Clinical and Educational Supervision is well established in providing a support structure for trainees, we believed that a peer mentoring relationship, (with allocation of a Higher Psychiatry Trainee as mentor), would be of additional benefit.It was hoped that the scheme would prove mutually beneficial to both mentee and mentor.MethodWe delivered a presentation at CT1 induction and sent out follow-up emails to encourage participation. Higher trainees were also sent information via email and asked to complete a basic application form if interested in becoming a mentor. Prospective mentors then attended a one-day training session.Two lead mentors, (also higher trainees), were allocated to oversee the scheme, with additional supervision from two lead Consultants. Mentor-Mentee matches were made based on information such as location, sub-specialty affiliations and outside interests.Matched pairs were advised about the intended frequency and nature of contacts. Check-in emails were sent halfway through the year and feedback evaluations completed at the end.Result95% of trainees who completed the evaluations said they would recommend the scheme to colleagues.Mentees reported benefits in terms of personal and professional development, whilst mentors reported improved listening, coaching, and supervisory skills.A small number of trainees highlighted that 6 monthly rotations impacted on ability to maintain face to face contacts.Recruitment and engagement have improved annually. We are currently running the third year of the scheme and have achieved 100% uptake amongst CT1s and are over-subscribed with mentors, (19 mentors to 13 mentees).ConclusionThe majority of feedback received has been positive and interest in the scheme continues to grow.Potential issues relating to location of postings has been overcome, at least in part, by recent changes to ways of working and the use of alternative forms of contact, such as video calling.Having exceeded demand in terms of mentor recruitment, we hope to extend the scheme to include trainees of other grades, and particularly those who are new to Northern Ireland.We are excited to see where the next stage of our journey takes us and hope that others will be inspired to embark on similar schemes within their areas of work.

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