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https://www.readbyqxmd.com/read/27873299/using-the-manchester-triage-system-for-refusing-nonurgent-patients-in-the-emergency-department-a-30-day-outcome-study
#1
Roger Daglius Dias, Izabel Cristina Rios, Carlos Luis Benites Canhada, Maria Dolores Galinanes Otero Fernandes, Leila Suemi Harima Letaif, Eloisa Bonfá, Maria Beatriz Moliterno Perondi
OBJECTIVE: To evaluate the long-term outcomes and satisfaction of nonurgent patients who seek care in the emergency department (ED) and are diverted to primary health services (PHS). METHODS: Data were collected from 264 nonurgent patients diverted from the ED of a tertiary public university hospital in São Paulo, Brazil. The nonurgent patient definition was performed by Manchester triage system version II (MTS-II) associated to medical interview in the triage service...
September 2016: Journal of Emergency Management: JEM
https://www.readbyqxmd.com/read/27855964/interventions-to-reduce-emergency-department-utilisation-a-review-of-reviews
#2
Koen Van den Heede, Carine Van de Voorde
OBJECTIVE: To describe policy interventions that have the objective to reduce ED use and to estimate their effectiveness. METHODS: Narrative review by searching three electronic databases for scientific literature review papers published between 2010 and October 2015. The quality of the included studies was assessed with AMSTAR, and a narrative synthesis of the retrieved papers was applied. RESULTS: Twenty-three included publications described six types of interventions: (1) cost sharing; (2) strengthening primary care; (3) pre-hospital diversion (including telephone triage); (4) coordination; (5) education and self-management support; (6) barriers to access emergency departments...
December 2016: Health Policy
https://www.readbyqxmd.com/read/27785689/complications-of-feeding-jejunostomy-tubes-in-patients-with-gastroesophageal-cancer
#3
Audrey H Choi, Michael P O'Leary, Shaila J Merchant, Virginia Sun, Joseph Chao, Dan J Raz, Jae Y Kim, Joseph Kim
BACKGROUND: Feeding jejunostomy tubes (FJT) in patients undergoing resection of gastroesophageal cancers facilitate perioperative nutrition. Data regarding FJT use and complications are limited. STUDY DESIGN: A single institution review was performed for patients who underwent perioperative FJT placement for gastrectomy or esophagogastrectomy from 2007 to 2015. FJT-related and unrelated complications were evaluated. RESULTS: FJTs were inserted for total/completion gastrectomy (n = 49/117, 41...
October 26, 2016: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/27779363/predictors-for-clinical-deterioration-of-mental-state-in-patients-assessed-by-telephone-based-mental-health-triage
#4
Natisha Sands, Stephen Elsom, Rebecca Corbett, Sandra Keppich-Arnold, Roshani Prematunga, Michael Berk, Julie Considine
Patient safety research focussing on recognizing and responding to clinical deterioration is gaining momentum in generalist health, but has received little attention in mental health settings. The focus on early identification and prompt intervention for clinical deterioration enshrined in patient safety research is equally relevant to mental health, especially in triage and crisis care contexts, yet the knowledge gap in this area is substantial. The present study was a controlled cohort study (n = 817) that aimed to identify patient and service characteristics associated with clinical deterioration of mental state indicated by unplanned admission to an inpatient psychiatric unit following assessment by telephone-based mental health triage...
October 25, 2016: International Journal of Mental Health Nursing
https://www.readbyqxmd.com/read/27756434/triage-treatment-and-transfer-of-patients-with-stroke-in-emergency-department-trial-the-t-3-trial-a-cluster-randomised-trial-protocol
#5
Sandy Middleton, Chris Levi, Simeon Dale, N Wah Cheung, Elizabeth McInnes, Julie Considine, Catherine D'Este, Dominique A Cadilhac, Jeremy Grimshaw, Richard Gerraty, Louise Craig, Verena Schadewaldt, Patrick McElduff, Mark Fitzgerald, Clare Quinn, Greg Cadigan, Sonia Denisenko, Mark Longworth, Jeanette Ward
BACKGROUND: Internationally recognised evidence-based guidelines recommend appropriate triage of patients with stroke in emergency departments (EDs), administration of tissue plasminogen activator (tPA), and proactive management of fever, hyperglycaemia and swallowing before prompt transfer to a stroke unit to maximise outcomes. We aim to evaluate the effectiveness in EDs of a theory-informed, nurse-initiated, intervention to improve multidisciplinary triage, treatment and transfer (T(3)) of patients with acute stroke to improve 90-day death and dependency...
October 18, 2016: Implementation Science: IS
https://www.readbyqxmd.com/read/27752635/a-study-on-the-disaster-medical-response-during-the-mauna-ocean-resort-gymnasium-collapse
#6
Myeong-Il Cha, Gi Woon Kim, Chu Hyun Kim, Minhong Choa, Dai Hai Choi, Inbyung Kim, Soon Joo Wang, In Sool Yoo, Han Deok Yoon, Kang Hyun Lee, Suck Ju Cho, Tag Heo, Eun Seog Hong
OBJECTIVE: To investigate and document the disaster medical response during the Gyeongju Mauna Ocean Resort gymnasium collapse on February 17, 2014. METHODS: Official records of each institution were verified to select the study population. All the medical records and emergency medical service run sheets were reviewed by an emergency physician. Personal or telephonic interviews were conducted, without a separate questionnaire, if the institutions or agencies crucial to disaster response did not have official records or if information from different institutions was inconsistent...
September 2016: Clin Exp Emerg Med
https://www.readbyqxmd.com/read/27746223/diagnosing-surgical-site-infection-using-wound-photography-a-scenario-based-study
#7
Patrick C Sanger, Vlad V Simianu, Cameron E Gaskill, Cheryl Al Armstrong, Andrea L Hartzler, Ross J Lordon, William B Lober, Heather L Evans
BACKGROUND: Postoperative surgical site infections (SSI) are common and costly. Most occur post-discharge, and may result in potentially preventable readmission and/or unnecessary urgent evaluation. Mobile health approaches incorporating patient-generated wound photos are being implemented in an attempt to optimize triage and management. We assessed how adding wound photos to existing data sources modifies provider decision-making. STUDY DESIGN: Web-based simulation survey using convenience sample of providers with expertise in surgical infections...
October 13, 2016: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/27742622/effect-of-a-national-urgent-care-telephone-triage-service-on-population-perceptions-of-urgent-care-provision-controlled-before-and-after-study
#8
E Knowles, A O'Cathain, J Turner, J Nicholl
OBJECTIVE: To measure the effect of an urgent care telephone service NHS 111 on population perceptions of urgent care. DESIGN: Controlled before and after population survey, using quota sampling to identify 2000 respondents reflective of the age/sex profile of the general population. SETTING: England. 4 areas where NHS 111 was introduced, and 3 control areas where NHS 111 had yet to be introduced. PARTICIPANTS: 28 071 members of the general population, including 2237 recent users of urgent care...
October 14, 2016: BMJ Open
https://www.readbyqxmd.com/read/27721659/rate-of-proven-rheumatic-diseases-in-a-large-collective-of-referrals-to-an-outpatient-rheumatology-clinic-under-routine-conditions
#9
Martin Feuchtenberger, Axel Philipp Nigg, Michael Rupert Kraus, Arne Schäfer
The prognostic significance of early diagnosis and therapeutic intervention in inflammatory rheumatic diseases has been well documented. However, a shortage of rheumatologists often impedes this approach in clinical practice. Therefore, it is of importance to identify those patients referred for diagnosis who would benefit most from a specialist's care. We applied a telephone-based triage for appointment allocation during routine care. This retrospective, monocentric analysis evaluated the efficacy of our triage to identify patients with rheumatic disease with special regard to initial appointment category (elective, early arthritis clinic (EAC), or emergency appointment)...
2016: Clinical Medicine Insights. Arthritis and Musculoskeletal Disorders
https://www.readbyqxmd.com/read/27714649/telephone-delivered-stepped-collaborative-care-for-treating-anxiety-in-primary-care-a-randomized-controlled-trial
#10
Bruce L Rollman, Bea Herbeck Belnap, Sati Mazumdar, Kaleab Z Abebe, Jordan F Karp, Eric J Lenze, Herbert C Schulberg
BACKGROUND: Collaborative care for depression is more effective in improving treatment outcomes than primary care physicians' (PCPs) usual care (UC). However, few trials of collaborative care have targeted anxiety. OBJECTIVE: To examine the impact and 12-month durability of a centralized, telephone-delivered, stepped collaborative care intervention (CC) for treating anxiety disorders across a network of primary care practices. DESIGN: Randomized controlled trial with blinded outcome assessments...
October 6, 2016: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/27692013/a-comparative-study-of-patient-characteristics-opinions-and-outcomes-for-patients-who-leave-the-emergency-department-before-medical-assessment
#11
Jacqueline Fraser, Paul Atkinson, Audra Gedmintas, Michael Howlett, Rose McCloskey, James French
OBJECTIVE: The emergency department (ED) left-without-being-seen (LWBS) rate is a performance indicator, although there is limited knowledge about why people leave, or whether they seek alternate care. We studied characteristics of ED LWBS patients to determine factors associated with LWBS. METHODS: We collected demographic data on LWBS patients at two urban hospitals. Sequential LWBS patients were contacted and surveyed using a standardized telephone survey. A matched group of patients who did not leave were also surveyed...
October 3, 2016: CJEM
https://www.readbyqxmd.com/read/27647060/a-post-discharge-smoking-cessation-intervention-for-hospital-patients-helping-hand-2-randomized-clinical-trial
#12
Nancy A Rigotti, Hilary A Tindle, Susan Regan, Douglas E Levy, Yuchiao Chang, Kelly M Carpenter, Elyse R Park, Jennifer H K Kelley, Joanna M Streck, Zachary Z Reid, Thomas Ylioja, Michele Reyen, Daniel E Singer
INTRODUCTION: Hospitalization provides an opportunity for smokers to quit, but tobacco-cessation interventions started in hospital must continue after discharge to be effective. This study aimed to improve the scalability of a proven effective post-discharge intervention by incorporating referral to a telephone quitline, a nationally available cessation resource. STUDY DESIGN: A three-site RCT compared Sustained Care, a post-discharge tobacco-cessation intervention, with Standard Care among hospitalized adult smokers who wanted to quit smoking and received in-hospital tobacco-cessation counseling...
October 2016: American Journal of Preventive Medicine
https://www.readbyqxmd.com/read/27626185/nurses-work-with-sick-leave-questions-by-telephone-in-primary-healthcare
#13
Linda Lännerström, Anna-Sophia von Celsing, Inger K Holmström, Thorne Wallman
AIMS AND OBJECTIVES: To describe nurses' work with sick leave questions by telephone. BACKGROUND: In Sweden, when a sick person needs to request a sickness certification it is common to contact the primary healthcare centre. The main access to primary healthcare is by telephone, with a nurse answering the care seeker's questions, triaging and helping care seekers to the right level of care. Nurses' work with sick leave questions has not been studied, except for two qualitative interview studies...
September 14, 2016: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/27603141/acute-gastroenteritis-and-campylobacteriosis-in-swiss-primary-care-the-viewpoint-of-general-practitioners
#14
Philipp J Bless, Joan Muela Ribera, Claudia Schmutz, Andreas Zeller, Daniel Mäusezahl
Acute gastroenteritis (AG) is frequently caused by infectious intestinal diseases (IID) including food- and waterborne pathogens of public health importance. Among these pathogens, Campylobacter spp. plays a major role. Many European countries monitor selected IIDs within disease surveillance systems. In Switzerland, the information on IIDs is restricted to limited surveillance data, while no data is available for AG. We conducted a qualitative study among Swiss general practitioners (GPs) to investigate the case management of AG and campylobacteriosis patients, the associated disease burden and the determinants leading to registration in the National Notification System for Infectious Diseases (NNSID)...
2016: PloS One
https://www.readbyqxmd.com/read/27545100/implementation-of-a-telephone-postoperative-clinic-in-an-integrated-health-system
#15
Kristy Kummerow Broman, Christianne L Roumie, Melissa K Stewart, Jason A Castellanos, John L Tarpley, Robert S Dittus, Richard A Pierce
BACKGROUND: Earlier work suggested that telephone follow-up could be used in lieu of in-person follow-up after surgery, saving patients time and travel and maximizing use of scarce surgeon and facility resources. We report our experience implementing and evaluating telephone postoperative follow-up within an integrated health system. STUDY DESIGN: We conducted a pre-post evaluation of a general surgery telephone postoperative clinic at a tertiary care Veterans Affairs facility from April 2015 to February 2016...
October 2016: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/27540738/an-audit-of-acute-oncology-services-patient-experiences-of-admission-procedures-and-staff-utilisation-of-a-new-telephone-triage-system
#16
Lorraine Warrington, Patricia Holch, Lucille Kenyon, Ceri Hector, Krystina Kozlowska, Anne Marie Kenny, Lucy Ziegler, Galina Velikova
OBJECTIVES: In 2010, St. James Institute of Oncology (Leeds, UK) created a new acute oncology service (AOS) consisting of a new admissions unit with a nurse-led telephone triage (TT) system. This audit cycle (March 2011 and June 2013) evaluated patient experiences of the reconfigured AOS and staff use of the TT system. METHODS: Patient views were elicited via a questionnaire and semi-structured interviews. The TT forms were analysed descriptively evaluating completion and data quality, reported symptoms and their severity and advice given (including admission rates)...
August 19, 2016: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/27538946/process-evaluation-for-complex-interventions-in-health-services-research-analysing-context-text-trajectories-and-disruptions
#17
Jamie Murdoch
BACKGROUND: Process evaluations assess the implementation and sustainability of complex healthcare interventions within clinical trials, with well-established theoretical models available for evaluating intervention delivery within specific contexts. However, there is a need to translate conceptualisations of context into analytical tools which enable the dynamic relationship between context and intervention implementation to be captured and understood. METHODS: In this paper I propose an alternative approach to the design, implementation and analysis of process evaluations for complex health interventions through a consideration of trial protocols as textual documents, distributed and enacted at multiple contextual levels...
2016: BMC Health Services Research
https://www.readbyqxmd.com/read/27487992/patient-intention-and-self-reported-compliance-in-relation-to-emergency-department-attendance-after-using-an-after-hours-gp-helpline
#18
Rosemary McKenzie, David Dunt, Allison Yates
OBJECTIVE: To determine ED attendance and compliance with GP advice following a call to an after hours telephone triage and advice service. METHODS: A descriptive study of users' of an after hours helpline self-reported ED attendance and compliance with GP recommendation, based on routinely collected service data and telephone survey results for 2783 callers in 2011-2012. The outcome measure was self-reported health service utilisation following advice from a GP on an after hours helpline...
October 2016: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/27484430/-triage-in-primary-care-overkill
#19
F H Rutten, D L Zwart
Based on triage during out-of-hours emergency services with physical contact with patients, the Dutch Triage Standard - a telephone triage algorithm - has been developed for use in primary care out-of-hours services. However, it is also used in the daytime setting. We argue that this tool should be evaluated by actually evaluating the telephone contacts that are backed up during triage and using the final diagnoses of these contacts as the reference standard. We have serious doubts whether the Dutch Triage Standard is an effective tool in the primary care daytime setting with its very low prevalence of high urgency...
2016: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/27484425/-practice-assistant-sometimes-misses-urgent-request-for-help-telephone-triage-in-general-practice
#20
M Smits, S Hanssen, L Huibers, P Giesen
OBJECTIVE: To assess the organisation and appropriateness of telephone triage in general practices in the Netherlands. DESIGN: Cross-sectional observational study. METHODS: Via e-mail we invited all members of the Dutch Association of practice assistants to complete an online survey. The questionnaire included questions about practice assistants' background characteristics and the practices' triage organisation. Furthermore, they were asked to assess the indicated type of care for a number of fictive case scenarios involving a variety of health problems and levels of urgency...
2016: Nederlands Tijdschrift Voor Geneeskunde
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