RESUMO
OBJECTIVE: The aims of this study were to evaluate patients' opinions on a fetal cardiology telemedicine service compared with usual outpatient care, the effect of the telemedicine consultation on maternal anxiety and its impact on travel times and time absent from work. METHODS: Prospective study over 20 months. Eligible patients attended for routine anomaly scan followed by fetal echocardiogram transmitted to the regional centre with live guidance by a fetal cardiologist, followed by parental counselling. All patients were offered a fetal cardiology appointment at the regional centre. Structured questionnaires assessing maternal satisfaction, travel times/days off and anxiety scores completed at time of both fetal echocardiograms. RESULTS: Sixty-seven patients were recruited and 66 completed the study. Participants expressed very high satisfaction rates with fetal telecardiology, equivalent to face-to-face consultation. The telecardiology appointments were associated with significantly reduced travel times and days off work (p < 0.01). Expectant mothers expressed a clear inclination for a fetal cardiology appointment at the local hospital facilitated by telemedicine (p < 0.01). CONCLUSIONS: Fetal telecardiology is highly acceptable to patients and is even preferred compared with travelling to a regional centre. There are additional socio-economic benefits that should encourage the development of remote fetal cardiology services.
Assuntos
Serviço Hospitalar de Cardiologia , Doenças Fetais/diagnóstico , Cardiopatias/diagnóstico , Preferência do Paciente , Perinatologia/métodos , Telemedicina , Adolescente , Adulto , Assistência Ambulatorial/psicologia , Assistência Ambulatorial/estatística & dados numéricos , Ansiedade/epidemiologia , Ansiedade/etiologia , Serviço Hospitalar de Cardiologia/organização & administração , Serviço Hospitalar de Cardiologia/estatística & dados numéricos , Ecocardiografia/economia , Ecocardiografia/métodos , Feminino , Doenças Fetais/economia , Doenças Fetais/terapia , Cardiopatias/congênito , Cardiopatias/economia , Humanos , Preferência do Paciente/economia , Preferência do Paciente/estatística & dados numéricos , Satisfação do Paciente/estatística & dados numéricos , Perinatologia/organização & administração , Gravidez , Diagnóstico Pré-Natal/economia , Diagnóstico Pré-Natal/métodos , Encaminhamento e Consulta/organização & administração , Fatores Socioeconômicos , Telemedicina/economia , Telemedicina/métodos , Telemedicina/estatística & dados numéricos , Adulto JovemRESUMO
Blood bank management must ensure the correct blood product issuance in the right time. For this purpose, patient clinical and immuno-haematological data have to be taken into consideration. Inventory composition, by blood group and phenotype, blood product providing possibilities and transport delays are determining factors. Finally, a good management relies also on the use of consensually written procedures and the monitoring of pertinent indicators.