ABSTRACT
At an antenatal clinic in St. Thomas's Hospital, London, 246 expectant mothers were randomly allocated to hold either their own maternity case notes or the standard co-operation card. Information was collected on three occasions during their care on attitudes and health behaviour. Clinical outcomes were recorded and the effects of the two systems on clinic administration were observed. More of the notes group expressed satisfaction with most aspects of their care and delivery and significantly more of the notes group felt well informed and satisfied with their companion during labour. There were no differences in clinical outcomes between the two groups except that, for no identifiable systematic reason, there were more assisted deliveries among the notes group. A number of administrative advantages resulted from mothers holding their own notes and although initial reservations were found amongst professional staff interviewed at the start of the study, the results proved persuasive and the practice of giving mothers their own notes is now to be extended throughout the department.
Subject(s)
Medical Records , Patient Education as Topic , Prenatal Care , Adult , Consumer Behavior , Female , Health Behavior , Humans , London , Pregnancy , Random AllocationABSTRACT
After introducing a computer assisted repeat prescribing programme into a south London practice improvements were made in several aspects of practice organisation. Time was saved by doctors and receptionists; prescriptions were produced more rapidly; information in the records about drugs that were available for repeat prescription was improved; and queries from chemists about prescriptions were reduced. The costs of the system in terms of computer operator time were estimated. Computerising prescribing data provides a source of data that may be used to enable doctors to audit their own prescribing.
Subject(s)
Computers , Drug Prescriptions , Family Practice , Humans , London , Task Performance and AnalysisSubject(s)
Ethics, Medical , Home Care Services , Hospitalization , Natural Childbirth , Attitude of Health Personnel , Female , Humans , Patient Advocacy , Patient Participation , PregnancySubject(s)
Epilepsy/therapy , Family Practice/standards , Medical Audit , Aged , Humans , London , MaleABSTRACT
Despite the growing role of specialist obstetricians in intranatal care the importance of the general practitioner's role, especially in antenatal and postnatal care, is being increasingly recognized. We describe a new way of sharing care which involves the consultant obstetrician attending antenatal sessions at fortnightly intervals in the practice. In addition the antenatal record is retained by the patient herself who brings it to all attendances, both in the practice and at the hospital.We analysed the results of this arrangement and compared them with a controlled series of hospital patients and found some advantages for shared care arrangements including, in particular, a reduction in the number of different doctors seen by patients, a big reduction in the number of patients who were seen by more than three doctors, and an increase in the breast feeding rate at the time of discharge from hospital.
Subject(s)
Prenatal Care/methods , Family Practice , Female , Humans , Obstetrics , Pregnancy , United KingdomABSTRACT
A diagrammatic method of recording family and social history using a family tree is described. Its advantages are identified and details of the way it has been introduced into the records in one general practice are given.
