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Referral pathway

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https://www.readbyqxmd.com/read/28794660/a-renal-colic-fast-track-pathway-to-improve-waiting-times-and-outcomes-for-patients-presenting-to-the-emergency-department
#1
Omar Al Kadhi, Kate Manley, Madhavi Natarajan, Valmiki Lutchmedial, Abbi Forsyth, Kate Tabrett, Jonathan Betteridge, William Finch, Heinrich Hollis
INTRODUCTION: Renal colic is commonly encountered in the emergency department (ED). We validated a fast track renal colic (FTRC) initiative to decrease patient waiting times and streamline patient flow. METHOD: The FTRC pathway was devised according to the National Institute for Health and Care Excellence clinical summary criteria for the management of patients with suspected renal colic. ED triage nurses use the pathway to identify patients with likely renal colic suitable for fast track to analgesia, investigation and management...
2017: Open Access Emergency Medicine: OAEM
https://www.readbyqxmd.com/read/28789670/patient-centered-boundary-mechanisms-to-foster-intercultural-partnerships-in-health-care-a-case-study-in-guatemala
#2
Martin Hitziger, Mónica Berger Gonzalez, Eduardo Gharzouzi, Daniela Ochaíta Santizo, Regina Solis Miranda, Andrea Isabel Aguilar Ferro, Ana Vides-Porras, Michael Heinrich, Peter Edwards, Pius Krütli
BACKGROUND: Up to one half of the population in Africa, Asia and Latin America has little access to high-quality biomedical services and relies on traditional health systems. Medical pluralism is thus in many developing countries the rule rather than the exception, which is why the World Health Organization is calling for intercultural partnerships to improve health care in these regions. They are, however, challenging due to disparate knowledge systems and lack of trust that hamper understanding and collaboration...
August 8, 2017: Journal of Ethnobiology and Ethnomedicine
https://www.readbyqxmd.com/read/28781173/clinical-characteristics-and-risk-of-serious-disease-in-patients-referred-to-a-diagnostic-centre-a-cohort-study
#3
Esben Næser, Ulrich Fredberg, Henrik Møller, Peter Vedsted
BACKGROUND: Little is known about the clinical characteristics of patients referred to a diagnostic centre through the Danish urgent referral pathway for non-specific serious symptoms. We aimed at estimating the distribution of serious disease and the diagnostic value of clinical characteristics for the diagnosis of cancer and serious non-malignant disease in these patients. METHOD: A cohort study of 938 patients referred by their GP to the diagnostic centre at Silkeborg Regional Hospital...
August 3, 2017: Cancer Epidemiology
https://www.readbyqxmd.com/read/28780500/perinatal-risk-factors-for-neonatal-encephalopathy-an-unmatched-case-control-study
#4
Cally J Tann, Margaret Nakakeeto, Barbara A Willey, Margaret Sewegaba, Emily L Webb, Ibby Oke, Emmanuel Derek Mutuuza, Donald Peebles, Margaret Musoke, Kathryn A Harris, Neil J Sebire, Nigel Klein, Jennifer J Kurinczuk, Alison M Elliott, Nicola J Robertson
OBJECTIVE: Neonatal encephalopathy (NE) is the third leading cause of child mortality. Preclinical studies suggest infection and inflammation can sensitise or precondition the newborn brain to injury. This study examined perinatal risks factor for NE in Uganda. DESIGN: Unmatched case-control study. SETTING: Mulago National Referral Hospital, Kampala, Uganda. METHODS: 210 term infants with NE and 409 unaffected term infants as controls were recruited over 13 months...
August 5, 2017: Archives of Disease in Childhood. Fetal and Neonatal Edition
https://www.readbyqxmd.com/read/28777903/hypertension-screening-of-commercial-divers-from-an-occupational-medicine-perspective
#5
Alejandro Garbino, Robert W Sanders, Charles H Mathers
Hypertension is one of the most common chronic diseases in the world: in the United States, it affects one-third of the adult population. Most cases are primary hypertension - with no identified cause - and significantly increase risk for cardiovascular disease and stroke. At NASA's Neutral Buoyancy Laboratory (NBL), there is a cadre of professional divers who provide underwater support during extravehicular activity training (EVAs, commonly referred to as "spacewalks") for astronauts. The NBL occupational health program requires regular "work-site" physical exams, including blood pressure checks, on at least a weekly basis...
March 2017: Undersea & Hyperbaric Medicine: Journal of the Undersea and Hyperbaric Medical Society, Inc
https://www.readbyqxmd.com/read/28765261/burden-of-child-and-adolescent-obesity-on-health-services-in-england
#6
Russell M Viner, Sanjay Kinra, Dasha Nicholls, Tim Cole, Anthony Kessel, Deborah Christie, Billy White, Helen Croker, Ian C K Wong, Sonia Saxena
OBJECTIVE: To assess the numbers of obese children and young people (CYP) eligible for assessment and management at each stage of the childhood obesity pathway in England. DESIGN: Pathway modelling study, operationalising the UK National Institute for Health and Care Excellence guidance on childhood obesity management against national survey data. SETTING: Data on CYP aged 2-18 years from the Health Survey for England 2006 to 2013. MAIN OUTCOME MEASURES: Clinical obesity (body mass index (BMI) >98th centile), extreme obesity (BMI ≥99...
August 1, 2017: Archives of Disease in Childhood
https://www.readbyqxmd.com/read/28764806/the-relationship-of-primary-care-providers-to-dental-practitioners-in-rural-and-remote-australia
#7
Tony Barnett, Ha Hoang, Jackie Stuart, Len Crocombe
BACKGROUND: Rural residents have poorer oral health and more limited access to dental services than their city counterparts. In rural communities, health care professionals often work in an extended capacity due to the needs of the community and health workforce shortages in these areas. Improved links and greater collaboration between resident rural primary care and dental practitioners could help improve oral health service provision such that interventions are both timely, effective and lead to appropriate follow-up and referral...
August 1, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28764695/compliance-with-telephone-triage-advice-among-adults-aged-45%C3%A2-years-and-older-an-australian-data-linkage-study
#8
Duong Thuy Tran, Amy Gibson, Deborah Randall, Alys Havard, Mary Byrne, Maureen Robinson, Anthony Lawler, Louisa R Jorm
BACKGROUND: Middle-aged and older patients are prominent users of telephone triage services for timely access to health information and appropriate referrals. Non-compliance with advice to seek appropriate care could potentially lead to poorer health outcomes among those patients. It is imperative to assess the extent to which middle-aged and older patients follow triage advice and how this varies according to their socio-demographic, lifestyle and health characteristics as well as features of the call...
August 1, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28762623/clinical-and-economic-evaluation-of-a-case-management-service-for-patients-with-back-pain
#9
Judith Smith, Gillian Yeowell, Francis Fatoye
AIM: To evaluate the clinical-effectiveness and resource use associated with Case Management Services in a UK private sector DESIGN: An observational cohort study based on prospective data collection of patient reported outcome measures and data collection from an existing administrative health database. SETTING: A United Kingdom (UK) private healthcare provider PARTICIPANTS: Consecutive referrals into the Case Management Service over a three-month period. INTERVENTIONS: Participants were managed within the Case Management Service in accordance with usual pathways...
August 1, 2017: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/28759686/diagnostic-impact-and-cost-effectiveness-of-whole-exome-sequencing-for-ambulant-children-with-suspected-monogenic-conditions
#10
Tiong Yang Tan, Oliver James Dillon, Zornitza Stark, Deborah Schofield, Khurshid Alam, Rupendra Shrestha, Belinda Chong, Dean Phelan, Gemma R Brett, Emma Creed, Anna Jarmolowicz, Patrick Yap, Maie Walsh, Lilian Downie, David J Amor, Ravi Savarirayan, George McGillivray, Alison Yeung, Heidi Peters, Susan J Robertson, Aaron J Robinson, Ivan Macciocca, Simon Sadedin, Katrina Bell, Alicia Oshlack, Peter Georgeson, Natalie Thorne, Clara Gaff, Susan M White
Importance: Optimal use of whole-exome sequencing (WES) in the pediatric setting requires an understanding of who should be considered for testing and when it should be performed to maximize clinical utility and cost-effectiveness. Objectives: To investigate the impact of WES in sequencing-naive children suspected of having a monogenic disorder and evaluate its cost-effectiveness if WES had been available at different time points in their diagnostic trajectory. Design, Setting, and Participants: This prospective study was part of the Melbourne Genomics Health Alliance demonstration project...
July 31, 2017: JAMA Pediatrics
https://www.readbyqxmd.com/read/28759299/international-practice-in-care-provision-for-post-stroke-visual-impairment
#11
Fiona J Rowe
PURPOSE: This study sought to explore the practice of orthoptists internationally in care provision for poststroke visual impairment. METHODS: Survey questions were developed and piloted with clinicians, academics, and users. Questions addressed types of visual problems, how these were identified, treated, and followed up, care pathways in use, links with other professions, and referral options. The survey was approved by the institutional ethical committee. The survey was accessed via a web link that was circulated through the International Orthoptic Association member professional organisations to orthoptists...
July 31, 2017: Strabismus
https://www.readbyqxmd.com/read/28757409/beyond-plan-b-a-qualitative-study-of-canadian-pharmacists-emergency-contraception-counselling-practices
#12
Karen Wong, Susan Hum, Lisa McCarthy, Sheila Dunn
OBJECTIVE: Pharmacists are often the front-line health care providers for women seeking emergency contraception (EC). This study explored Ontario pharmacists' EC counselling practices and their perceived barriers to recommending the most effective EC method, the copper IUD (Cu-IUD). METHODS: This qualitative study used one-on-one, semistructured interviews with 20 pharmacists working in pharmacies located within a 1-km radius of a large sexual health clinic that offered postcoital IUDs in downtown Toronto...
July 28, 2017: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
https://www.readbyqxmd.com/read/28755510/raising-awareness-of-graves-orbitopathy-with-early-warning-cards
#13
Anna Mitchell, Janis Hickey, Bijay Vaidya, Rhianne Mason, Ramzi Ajjan, Nicola Zammitt, Petros Perros, Colin Dayan
BACKGROUND: Clinically significant Graves' orbitopathy (GO) develops in about 25% of those with Graves' disease (GD); most cases of GD in the UK are managed by endocrinologists. Despite this, patients report significant delays before a diagnosis of GO is made. Measures to increase awareness of the early signs of GO and establishing a fast-track referral pathway to specialist care should overcome these delays and potentially improve outcomes. AIMS: We aimed to determine whether issuing a "GO early warning card" to all GD patients raises awareness of GO and facilitates early diagnosis, what percentage of cards result in a telephone contact, the number of "false reports" from card carriers and patient perceptions of the cards...
July 29, 2017: Clinical Endocrinology
https://www.readbyqxmd.com/read/28752640/early-colposcopic-reassurance-and-discharge-to-routine-recall-does-not-increase-subsequent-high-grade-referral-or-treatment-rates
#14
M Macdonald, R Lyon, J Smith, J Tidy, J Palmer
BACKGROUND: The Jessop Wing Colposcopy Unit identified that between 1st April 2014 and 31st March 2015 the number of women referred with high-grade dyskaryosis and the number of women undergoing treatment increased by 21% and 19%, respectively. There was concern that referral and treatment rates were increasing because we were now seeing women, previously discharged to routine recall with prior low-grade cytology hrHPV positive, re-enter the system for their second round of screening...
July 27, 2017: Cytopathology: Official Journal of the British Society for Clinical Cytology
https://www.readbyqxmd.com/read/28751756/knowledge-or-noise-making-sense-of-general-practitioners-and-consultant-use-of-2-week-wait-referrals-for-suspected-cancer
#15
Conan Donnelly, Nigel Hart, Alan David McCrorie, Lesley Anderson, Michael Donnelly, Peter Murchie, Anna Gavin
BACKGROUND: Early diagnosis and treatment of cancer is the goal of the 2-week-wait referral pathway (2WW). Variation exists between General Practice use of 2WW and rates of consultant reprioritisation of GP referral from routine to 2WW (Consultant Upgrade). We investigated variation in General Practice and Consultant Upgrade 2WW referral activity. METHODS: Data from 185 000 referrals and 29 000 cancers recorded between 2011 and 2013 from the Northern Ireland Cancer Waiting Time database (CaPPS) were analysed to ascertain standardised referral rate ratios, detection rate (DR) (=sensitivity) and conversion rate (CR) (=positive predictive value) for Practice 2WW referrals and Consultant Upgrade 2WW...
July 27, 2017: British Journal of Cancer
https://www.readbyqxmd.com/read/28729006/a-representative-assessment-of-the-management-of-open-fractures-of-the-lower-limb-within-uk-orthoplastic-centres-a-two-centre-audit-of-compliance-with-national-standards
#16
B Rymer, E O F Dimovska, D T S Chou, R Choa, B Davis, S Huq
BACKGROUND: Open fractures of the lower limb represent a complex and varied array of injuries. The BOAST 4 document produced by BAPRAS and the BOA provides standards on how to manage these patients, and NICE have recently produced additional guidance. We aimed to assess concordance with these standards in a large cohort representative of UK orthoplastic centres. METHODS: Patients admitted to the orthoplastic units at Norfolk and Norwich University Hospital and Royal Stoke University Hospital with open lower limb fractures between 2009 and 2014 were included...
July 11, 2017: Injury
https://www.readbyqxmd.com/read/28725581/direct-magnetic-resonance-imaging-guided-biopsy-of-the-prostate-lessons-learned-in-establishing-a-regional-referral-center
#17
REVIEW
Benjamin Addicott, Bryan R Foster, Chenara Johnson, Alice Fung, Christopher L Amling, Fergus V Coakley
MRI-targeted biopsy of the prostate appears to have the potential to reduce the high rates of underdiagnosis and overdiagnosis associated with the current diagnostic standard of transrectal ultrasound guided systematic biopsy. Direct or "in bore" MRI-guided biopsy is one of the three methods for MRI-targeted core needle sampling of suspicious, generally Pi-RADS 4 or 5, foci within the prostate, and our early experience suggests the approach demonstrates substantial utility and promise in the care of patients with prostate cancer...
June 2017: Translational Andrology and Urology
https://www.readbyqxmd.com/read/28724743/improving-the-healthcare-response-to-domestic-violence-and-abuse-in-sexual-health-clinics-feasibility-study-of-a-training-support-and-referral-intervention
#18
Alex Hardip Sohal, Neha Pathak, Sarah Blake, Vanessa Apea, Judith Berry, Jayne Bailey, Chris Griffiths, Gene Feder
OBJECTIVES: Sexual health and gynaecological problems are the most consistent and largest physical health differences between abused and non-abused female populations. Sexual health services are well placed to identify and support patients experiencing domestic violence and abuse (DVA). Most sexual health professionals have had minimal DVA training despite English National Institute for Health and Care Excellence recommendations. We sought to determine the feasibility of an evidence-based complex DVA training intervention in female sexual health walk-in services (IRIS ADViSE: Identification and Referral to Improve Safety whilst Assessing Domestic Violence in Sexual Health Environments)...
July 19, 2017: Sexually Transmitted Infections
https://www.readbyqxmd.com/read/28719230/help-seeking-for-mental-health-problems-in-an-adolescent-population-the-effect-of-gender
#19
L Haavik, I Joa, K Hatloy, H J Stain, J Langeveld
BACKGROUND: While the onset of many mental health problems occurs in adolescence, these problems are severely undertreated in this age group. To inform early intervention for adolescents, we investigated the effect of gender and education type on perception of barriers to help seeking, mental health literacy, and the awareness and use of mental health services. METHOD: A web-based survey using vignettes, open-ended and multiple choice items was administered to upper secondary school students in two counties in Norway...
July 18, 2017: Journal of Mental Health
https://www.readbyqxmd.com/read/28719134/development-and-implementation-of-a-clinical-pathway-for-cardiac-surgery-in-the-intensive-care-unit-effects-on-protocol-adherence
#20
Marion van der Kolk, Mark van den Boogaard, Corine Ter Brugge-Speelman, Jeroen Hol, Luc Noyez, Kees van Laarhoven, Hans van der Hoeven, Peter Pickkers
RATIONALE, AIMS AND OBJECTIVES: Cardiac surgery (CS) is facilitated by multiple perioperative guidelines and protocols. Use of a clinical pathway (CP) may facilitate the care of these patients. METHODS: This is a pre-post design study in the ICU of a tertiary referral centre. A CP for CS patients in the ICU was developed by ICU-nurses and enabled them to execute proactively predefined actions in accordance with and within the preset boundaries which were part of a variance report...
July 18, 2017: Journal of Evaluation in Clinical Practice
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