Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 69.988
Filtrar
1.
Bone Joint J ; 103-B(2): 347-352, 2021 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-33517742

RESUMEN

AIMS: Surgical costs are a major component of healthcare expenditures in the USA. Intraoperative communication is a key factor contributing to patient outcomes. However, the effectiveness of communication is only partially determined by the surgeon, and understanding how non-surgeon personnel affect intraoperative communication is critical for the development of safe and cost-effective staffing guidelines. Operative efficiency is also dependent on high-functioning teams and can offer a proxy for effective communication in highly standardized procedures like primary total hip and knee arthroplasty. We aimed to evaluate how the composition and dynamics of surgical teams impact operative efficiency during arthroplasty. METHODS: We performed a retrospective review of staff characteristics and operating times for 112 surgeries (70 primary total hip arthroplasties (THAs) and 42 primary total knee arthroplasties (TKAs)) conducted by a single surgeon over a one-year period. Each surgery was evaluated in terms of operative duration, presence of surgeon-preferred staff, and turnover of trainees, nurses, and other non-surgical personnel, controlling cases for body mass index, presence of osteoarthritis, and American Society of Anesthesiologists (ASA) score. RESULTS: Turnover among specific types of operating room staff, including the anaesthesiologist (p = 0.011), circulating nurse (p = 0.027), and scrub nurse (p = 0.006), was significantly associated with increased operative duration. Furthermore, the presence of medical students and nursing students were associated with improved intraoperative efficiency in TKA (p = 0.048) and THA (p = 0.015), respectively. The presence of surgical fellows (p > 0.05), vendor representatives (p > 0.05), and physician assistants (p > 0.05) had no effect on intraoperative efficiency. Finally, the presence of the surgeon's 'preferred' staff did not significantly shorten operative duration, except in the case of residents (p = 0.043). CONCLUSION: Our findings suggest that active management of surgical team turnover and composition may provide a means of improving intraoperative efficiency during THA and TKA. Cite this article: Bone Joint J 2021;103-B(2):347-352.


Asunto(s)
Artroplastia de Reemplazo de Cadera , Artroplastia de Reemplazo de Rodilla , Eficiencia Organizacional , Grupo de Atención al Paciente/organización & administración , Humanos , Relaciones Interprofesionales , Tempo Operativo , Reorganización del Personal , Estudios Retrospectivos
2.
BMJ Open Qual ; 10(1)2021 02.
Artículo en Inglés | MEDLINE | ID: mdl-33579746

RESUMEN

Effective communication between members of the multidisciplinary team is imperative for patient safety. Within the Medicine for the Elderly wards at Royal Victoria Hospital (RVH) in Dundee, we identified an inefficient process of information-sharing between the orthopaedics outpatient department (OPD) at the main teaching hospital and our hospital's rehabilitation teams, and sought to improve this by introducing several changes to the work system. Our aim was for all patients who attended the OPD clinic to have a plan communicated to the RVH team within 24 hours.Before our intervention, clinic letters containing important instructions for ongoing rehabilitation were dictated by the OPD team, transcribed and uploaded to an electronic system before the RVH team could access them. We analysed clinic attendances over a 4-week period and found that it took 15 days on average for letters to be shared with the RVH teams. We worked with both teams to develop a clinical communication tool and new processes, aiming to expedite the sharing of key information. Patients attended the OPD with this form, the clinician completed it at the time of their appointment and the form returned with the patient to RVH on the same day.We completed multiple Plan-Do-Study-Act cycles; before our project was curtailed by the COVID-19 pandemic. During our study period, seven patients attended the OPD with a form, with all seven returning to RVH with a completed treatment plan documented by the OPD clinician. This allowed rehabilitation teams to have access to clinic instructions generated by orthopaedic surgeons almost immediately after a patient attended the clinic, essentially eliminating the delay in information-sharing.The introduction of a simple communication tool and processes to ensure reliable transfer of information can expedite information-sharing between secondary care teams and can potentially reduce delays in rehabilitation.


Asunto(s)
/rehabilitación , Servicios de Salud para Ancianos/normas , Grupo de Atención al Paciente/normas , Mejoramiento de la Calidad , Atención Secundaria de Salud/normas , Anciano , Anciano de 80 o más Años , Comunicación , Femenino , Humanos , Relaciones Interprofesionales , Masculino , Atención Secundaria de Salud/métodos
3.
BMC Surg ; 21(1): 89, 2021 Feb 18.
Artículo en Inglés | MEDLINE | ID: mdl-33602217

RESUMEN

BACKGROUND: Mesenteric ischemia is associated with poor outcome and high overall mortality. The aim was to analyze an interdisciplinary treatment approach of vascular and visceral specialists focusing on the in-hospital outcome and follow-up in patients with acute and acute-on-chronic mesenteric ischemia. METHODS: From 2010 until 2017, 26 consecutive patients with acute or acute on chronic mesenteric ischemia were treated by an interdisciplinary team. Data were prospectively collected and retrospectively evaluated. Throughout the initial examination, the extent of bowel resection was determined by the visceral surgeon and the appropriate mode of revascularization by the vascular surgeon. The routine follow-up included clinical examination and ultrasound- or CT-imaging for patency assessment and overall survival as primary endpoint of the study. RESULTS: Out of 26 patients, 18 (69.2%) were rendered for open repair. Ten patients (38.5%) received reconstruction of the superior mesenteric artery with an iliac-mesenteric bypass. Seven patients (26.9%) underwent thrombembolectomy of the mesenteric artery. One patient received an infra-diaphragmatic aorto-celiac-mesenteric bypass. Out of the 8 patients, who were not suitable for open revascularization, 2 patients (7.7%) were treated endovascularly and 6 (23.1%) underwent explorative laparotomy. The in-hospital mortality was 23% (n = 6). The mean survival of the revascularized group (n = 20) was 51.8 months (95% CI 39.1-64.5) compared to 15.7 months in the non-revascularized group (n = 6) (95% CI - 4.8-36.1; p = 0.08). The median follow-up was 64.6 months. Primary patency in the 16 patients after open and 2 after interventional revascularization was 100% and 89.9% in the follow-up. CONCLUSION: The interdisciplinary treatment of mesenteric ischemia improves survival if carried out in time. Hereby open revascularization measures are advantageous as they allow bowel assessment, resection, and revascularization in a one-stop fashion especially in advanced cases.


Asunto(s)
Servicios Médicos de Urgencia , Isquemia Mesentérica , Grupo de Atención al Paciente , Enfermedad Aguda , Servicios Médicos de Urgencia/métodos , Humanos , Arteria Mesentérica Superior/cirugía , Isquemia Mesentérica/cirugía , Estudios Retrospectivos , Resultado del Tratamiento , Procedimientos Quirúrgicos Vasculares/métodos
4.
BMC Fam Pract ; 22(1): 31, 2021 02 03.
Artículo en Inglés | MEDLINE | ID: mdl-33535973

RESUMEN

BACKGROUND: Interprofessional primary care (IPC) teams provide comprehensive and coordinated care and are ideally equipped to support those populations most at risk of adverse health outcomes during the COVID-19 pandemic, including older adults, and patients with chronic physical and mental health conditions. There has been little focus on the experiences of healthcare teams and no studies have examined IPC practice during the early phase of the COVID-19 pandemic. The objective of the study was to describe the state of interprofessional health provider practice within IPC teams during the COVID-19 pandemic. METHODS: Observational cross-sectional design. A web-based survey was deployed to IPC providers working in team-based primary care clinics in the province of Ontario, Canada. The survey included 26 close-ended and six open-ended questions. Close-ended questions were analyzed using descriptive statistics. Content analysis was used to analyze the open-ended questions. RESULTS: 445 surveys were included in the final analysis. Service delivery shifted from in-person care (77% pre-COVID-19) to telephone (76.5% during the COVID-19 pandemic). Less than half of the respondents (40%) reported receiving any training for virtual delivery. Wait times to access team members were reported to have decreased. There has also been a shift in what IPC providers report as the most commonly seen conditions, with increases in visits related to mental health concerns, acute infections (including COVID-19), social isolation, and resource navigation. Respondents also reported a reduction in healthcare provision for multiple chronic conditions including diabetes, cardiovascular disease, and chronic pain. CONCLUSIONS: IPC teams are rapidly shifting their practice to supporting their patients during the pandemic. A surge in mental health issues has been seen and is expected to continue to increase in response to COVID-19. Understanding early experiences can help plan for future pandemic waves.


Asunto(s)
/epidemiología , Relaciones Interprofesionales , Atención Primaria de Salud/métodos , Estudios Transversales , Humanos , Trastornos Mentales/diagnóstico , Trastornos Mentales/epidemiología , Trastornos Mentales/terapia , Ontario/epidemiología , Grupo de Atención al Paciente/organización & administración , Grupo de Atención al Paciente/estadística & datos numéricos , Pautas de la Práctica en Medicina/estadística & datos numéricos , Atención Primaria de Salud/estadística & datos numéricos , Encuestas y Cuestionarios
5.
BMC Health Serv Res ; 21(1): 89, 2021 Jan 26.
Artículo en Inglés | MEDLINE | ID: mdl-33499869

RESUMEN

BACKGROUND: The indication for prescribing a particular medication, or its reason for use (RFU) is a crucial piece of information for all those involved in the circle of care. Research has shown that sharing RFU information with physicians, pharmacists and patients improves patient safety and patient adherence, however RFU is rarely added on prescriptions by prescribers or on medication labels for patients to reference. METHODS: Qualitative interviews were conducted with 20 prescribers in Southern Ontario, Canada, to learn prescribers' current attitudes on the addition of RFU on prescriptions and medication labels. A trained interviewer used a semi-structured interview guide for each interview. The interviews explored how the sharing of RFU information would impact prescribers' workflows and practices. Interviews were recorded, transcribed and thematically coded. RESULTS: The analysis yielded four main themes: Current Practice, Future Practice, Changing Culture, and Collaboration. Most of the prescribers interviewed do not currently add RFU to prescriptions. Prescribers were open to sharing RFU with colleagues via a regional database but wanted the ability to provide context for the prescribed medication within the system. Many prescribers were wary of the impact of adding RFU on their workflow but felt it could save time by avoiding clarifying questions from pharmacists. Increased interprofessional collaboration, increased patient understanding of prescribed medications, avoiding guesswork when determining indications and decreased misinterpretation regarding RFU were cited by most prescribers as benefits to including RFU information. CONCLUSIONS: Prescribers were generally open to sharing RFU and clearly identified the benefits to pharmacists and patients if added. Critically, they also identified benefits to their own practices. These results can be used to guide the implementation of future initiatives to promote the sharing of RFU in healthcare teams.


Asunto(s)
Etiquetado de Medicamentos , Prescripciones de Medicamentos , Humanos , Ontario , Grupo de Atención al Paciente , Seguridad del Paciente , Medicamentos bajo Prescripción
7.
BMJ Case Rep ; 14(1)2021 Jan 11.
Artículo en Inglés | MEDLINE | ID: mdl-33431443

RESUMEN

Pubic osteomyelitis is a rare and often late-onset complication of radiation therapy and surgery for vulvar and vaginal carcinoma. It typically presents with vulvar pain, fever, vaginal discharge and/or gait disorders. Pubic osteomyelitis is often accompanied by fistulas or wound dehiscence in the pelvic area. Its accurate diagnosis and treatment are challenging and require a multidisciplinary team effort. In our patients, multiple combined surgical procedures, long-term antibiotic treatment and days to weeks of hospital admission were necessary to treat pubic osteomyelitis. We emphasise the importance of timely and adequate diagnosis and multidisciplinary approach resulting in a course of treatment that is as effective as possible, limiting the impact on quality of life, which is generally high in this group of patients.


Asunto(s)
Carcinoma/terapia , Quimioradioterapia Adyuvante/efectos adversos , Osteomielitis/terapia , Traumatismos por Radiación/terapia , Herida Quirúrgica/terapia , Neoplasias de la Vulva/terapia , Adulto , Antibacterianos/uso terapéutico , Artrodesis , Trasplante Óseo , Carcinoma/patología , Femenino , Humanos , Aplicación de Sanguijuelas , Imagen por Resonancia Magnética , Persona de Mediana Edad , Osteomielitis/diagnóstico , Osteomielitis/etiología , Grupo de Atención al Paciente , Hueso Púbico/diagnóstico por imagen , Hueso Púbico/efectos de la radiación , Hueso Púbico/cirugía , Traumatismos por Radiación/diagnóstico , Traumatismos por Radiación/etiología , Articulación Sacroiliaca/diagnóstico por imagen , Articulación Sacroiliaca/efectos de la radiación , Articulación Sacroiliaca/cirugía , Trasplante de Piel , Herida Quirúrgica/complicaciones , Resultado del Tratamiento , Vulva/patología , Vulva/cirugía , Neoplasias de la Vulva/patología
8.
Bull Cancer ; 108(2): 163-176, 2021 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-33455736

RESUMEN

Sarcomas are a rare heterogeneous group of malignant neoplasms that can arise in almost any anatomic site and any age. Close collaboration among adult and pediatric cancer specialists in the management of these tumors is of foremost importance. In this review, we present the current multidisciplinary organization in care of patients with sarcoma in France and we review the main advances made in the last decades in systemic and radiotherapy treatment in the main sarcoma types diagnosed in children, adolescents and young adults (AYA), thanks to the international collaboration.


Asunto(s)
Neoplasias Óseas/terapia , Instituciones Oncológicas , Grupo de Atención al Paciente/organización & administración , Sarcoma/terapia , Neoplasias de los Tejidos Blandos/terapia , Adolescente , Adulto , Factores de Edad , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Instituciones Oncológicas/organización & administración , Instituciones Oncológicas/provisión & distribución , Niño , Redes Comunitarias/organización & administración , Redes Comunitarias/provisión & distribución , Europa (Continente) , Francia , Humanos , Cooperación Internacional , Neoplasias Pulmonares/radioterapia , Neoplasias Pulmonares/secundario , Quimioterapia de Mantención , Oncología Médica , Persona de Mediana Edad , Recurrencia Local de Neoplasia/radioterapia , Neoplasias de Células Germinales y Embrionarias/terapia , Osteosarcoma/terapia , Dosificación Radioterapéutica , Ensayos Clínicos Controlados Aleatorios como Asunto , Rabdomiosarcoma/terapia , Sarcoma de Parte Blanda Alveolar/terapia , Sarcoma de Ewing/terapia , Sociedades Médicas , Adulto Joven
9.
Clin J Oncol Nurs ; 25(1): 56-60, 2021 Feb 01.
Artículo en Inglés | MEDLINE | ID: mdl-33480871

RESUMEN

BACKGROUND: The COVID-19 pandemic placed challenges on interprofessional communication patterns among clinical care teams at a time when effective communication was greatly needed. The development of enhanced systems for communication that integrate the latest evidence and communication technologies can offer a solution to this crisis. OBJECTIVES: This article provides a framework for ways in which nursing teams can develop evidence-based enhanced interprofessional communication systems during a pandemic. METHODS: Based on communication models and related technologies, this article reviews strategies to enhance interprofessional communication. Two case studies are included that illustrate how nursing teams can enhance communication during a pandemic. FINDINGS: To improve communication during a pandemic, clinicians can incorporate interprofessional communication models in clinical practice and apply enhanced communication strategies.


Asunto(s)
/psicología , Enfermería Basada en la Evidencia/normas , Comunicación Interdisciplinaria , Pandemias/prevención & control , Grupo de Atención al Paciente/normas , Guías de Práctica Clínica como Asunto , Adulto , Conducta Cooperativa , Femenino , Humanos , Masculino , Persona de Mediana Edad
10.
Z Gastroenterol ; 59(1): 43-49, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-33429449

RESUMEN

Non-cirrhotic portal vein thrombosis (PVT) in patients with antiphospholipid syndrome (APS) is a rare complication, and the management has to be determined individually based on the extent and severity of the presentation. We report on a 37-year-old male patient with non-cirrhotic chronic PVT related to a severe thrombophilia, comprising APS, antithrombin-, factor V- and factor X-deficiency. Three years after the initial diagnosis of non-cirrhotic PVT, the patient presented with severe hemorrhagic shock related to acute bleeding from esophageal varices, requiring an emergency transjugular intrahepatic portosystemic stent shunt (TIPSS). TIPSS was revised after a recurrent bleeding episode due to insufficient reduction of the portal pressure. Additionally, embolization of the dilated V. coronaria ventriculi led to the regression of esophageal varices but resulted simultaneously in a left-sided portal hypertension (LSPH) with development of stomach wall and perisplenic varices. After a third episode of acute esophageal varices bleeding, a surgical distal splenorenal shunt (Warren shunt) was performed to reduce the LSPH. Despite anticoagulation with low molecular weight heparin and antithrombin substitution, endoluminal thrombosis led to a complete Warren shunt occlusion, aggravating the severe splenomegaly and pancytopenia. Finally, a partial spleen embolization (PSE) was performed. In the postinterventional course, leukocyte and platelet counts increased rapidly and the patient showed no further bleeding episodes. Overall, this complex course demonstrates the need for individual assessment of multimodal treatment options in non-cirrhotic portal hypertension. This young patient required triple modality porto-systemic pressure reduction (TIPSS, Warren shunt, PSE) and involved finely balanced anticoagulation and bleeding control.


Asunto(s)
Várices Esofágicas y Gástricas/cirugía , Hemorragia Gastrointestinal/etiología , Hipertensión Portal/cirugía , Derivación Portosistémica Intrahepática Transyugular/métodos , Trombofilia , Trombosis de la Vena , Adulto , Várices Esofágicas y Gástricas/diagnóstico , Hemorragia Gastrointestinal/diagnóstico , Hemorragia Gastrointestinal/terapia , Humanos , Hipertensión Portal/diagnóstico , Masculino , Grupo de Atención al Paciente , Vena Porta/fisiopatología , Derivación Portosistémica Intrahepática Transyugular/efectos adversos , Stents
11.
N Z Med J ; 134(1528): 35-45, 2021 01 15.
Artículo en Inglés | MEDLINE | ID: mdl-33444305

RESUMEN

AIM: The New Zealand National Child Protection Alert System is administered by multidisciplinary teams in every district health board. The aim of this study was to investigate the factors that influence multidisciplinary child protection teams' (MDTs') decisions about whether to place a child protection alert. METHOD: Members of the Child Protection Alert System teams were invited to participate in semi-structured interviews. Interview data were coded and grouped into themes using inductive thematic analysis. RESULTS: Six themes were identified: the system works well; a wide range of factors are considered in multidisciplinary team decision-making; there are some difficulties with multidisciplinary team meetings; there are problems with the administration of the system across district health boards; there is concern about the potential for the Child Protection Alert System to stigmatise families or cause unjustified responses; improvements can be made to the system. CONCLUSION: There is overall support for the National Child Protection Alert System and a consensus that the benefits outweigh any potential risks. There is a need for further improvements to the system, including consistent training, further standardisation and increased accessibility of the information to health professionals, including making information on the system available to primary healthcare.


Asunto(s)
Servicios de Protección Infantil/estadística & datos numéricos , Toma de Decisiones , Personal de Salud , Grupo de Atención al Paciente/organización & administración , Atención Primaria de Salud/organización & administración , Investigación Cualitativa , Niño , Femenino , Humanos , Masculino , Nueva Zelanda , Estudios Retrospectivos
12.
Rev Col Bras Cir ; 48: e20202832, 2021.
Artículo en Inglés, Portugués | MEDLINE | ID: mdl-33503143

RESUMEN

The ACERTO project is a multimodal perioperative care protocol. Implemented in 2005, the project in the last 15 years has disseminated the idea of a modern perioperative care protocol, based on evidence and with interdisciplinary team work. Dozens of published studies, using the protocol, have shown benefits such as reduced hospital stay, postoperative complications and hospital costs. Disseminated in Brazil, the project is supported by the Brazilian College of Surgeons and the Brazilian Society of Parenteral and Enteral Nutrition, among others. This article compiles publications by the authors who belong to the CNPq research group "Acerto em Nutrição e Cirurgia", refers to the experience of other national authors in various surgical specialties, and finally outlines the evolution of the ACERTO project in the timeline.


Asunto(s)
Costos de Hospital/estadística & datos numéricos , Tiempo de Internación/estadística & datos numéricos , Atención Perioperativa/estadística & datos numéricos , Atención Perioperativa/tendencias , Brasil , Humanos , Terapia Nutricional , Grupo de Atención al Paciente , Atención Perioperativa/economía , Cuidados Posoperatorios , Complicaciones Posoperatorias , Cuidados Preoperatorios
13.
Br J Hosp Med (Lond) ; 82(1): 1-3, 2021 Jan 02.
Artículo en Inglés | MEDLINE | ID: mdl-33512291

RESUMEN

The COVID-19 pandemic has necessitated unprecedented changes to the functioning of hospitals across the world. This article evaluates the acute impact of COVID-19 on the provision of symptomatic breast services in the UK and explores suggestions for more sustainable functioning of services in the post-COVID-19 era.


Asunto(s)
Instituciones de Atención Ambulatoria/organización & administración , Neoplasias de la Mama/diagnóstico por imagen , Neoplasias de la Mama/terapia , Pandemias , Comunicación , Femenino , Marcadores Fiduciales , Humanos , Control de Infecciones , Mamografía , Moral , Grupo de Atención al Paciente , Consulta Remota , Reino Unido
15.
PLoS One ; 16(1): e0245473, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33444419

RESUMEN

BACKGROUND: The SARS-CoV-2 virus has spread rapidly around the globe since December 2019 creating much uncertainty among medical staff. Due to close patient contact, medical assistants are at increased risk of an infection. Several studies have investigated psychological consequences of the SARS-CoV-2 pandemic on medical staff, yet studies in the outpatient setting are scarce and studies addressing medical assistants are lacking. This study aimed to investigate pandemic-related stressors, attitudes, and work outcomes among medical assistants and to identify possible determinants. METHODS: The population under study were medical assistants across entire Germany. A self-devised online questionnaire was published between April 7th, 2020, and April 14th. including questions on pandemic-related stressors, attitudes and work outcomes. Additionally, symptoms of depression and anxiety disorder were measured by PHQ-2 and GAD-2, respectively. Logistic regression was performed to identify possible determinants. RESULTS: 2150 medical assistants provided complete data (98.0% female, mean age 37.6 years). Major stressors were uncertainty about the temporal scope of the pandemic (95.1% agreement), about how to act correctly (77.5%), feelings of not being allowed to let patients down (75.9%), uncertainty about one's financial situation (67.4%) and about contact persons for further information (67.1%). One third (29.9%) of the study population screened positively for depression and 42.6% for anxiety disorder. Feeling burdened by one's financial situation was significantly associated with working in specialist practices (1.32 [1.08-1.62]), caring for children (1.51 [1.22-1.87]), depression (1.28 [1.01-1.62]), and anxiety disorder (1.93 [1.55-2.39]). Feeling burdened by thoughts about virus contraction at work was also significantly associated with working in specialist practices (1.33 [1.07-1.64]), caring for children (1.33 [1.07-1.66]), depression (1.54 [1.18-2.00]), and anxiety (4.71 [3.71-5.98]). CONCLUSIONS: This study provides novel evidence regarding major SARS-CoV-2 pandemic-related stressors among medical assistants and suggests need for special support for medical assistants caring for children and working in specialist practices.


Asunto(s)
/epidemiología , Personal de Salud/psicología , Estrés Laboral/epidemiología , Estrés Psicológico/epidemiología , Adulto , Estudios Transversales , Femenino , Alemania/epidemiología , Humanos , Masculino , Estrés Laboral/psicología , Pandemias , Grupo de Atención al Paciente , /aislamiento & purificación
17.
BMC Musculoskelet Disord ; 22(1): 18, 2021 Jan 05.
Artículo en Inglés | MEDLINE | ID: mdl-33402136

RESUMEN

BACKGROUND: Like with all cancers, multidisciplinary team (MDT) meetings are the norm in bone and soft tissue tumour (BST) management too. Problem in attendance of specialists due to geographical location is the one of the key barriers to effective functioning of MDTs. To overcome this problem, virtual MDTs involving videoconferencing or telemedicine have been proposed, but however this has been seldom used and tested. The COVID-19 pandemic forced the implementation of virtual MDTs in the Oxford sarcoma service in order to maintain normal service provision. We conducted a survey among the participants to evaluate its efficacy. METHODS: An online questionnaire comprising of 24 questions organised into 4 sections was circulated among all participants of the MDT after completion of 8 virtual MDTs. Opinions were sought comparing virtual MDTs to the conventional face-to-face MDTs on various aspects. A total of 36 responses were received and were evaluated. RESULTS: 72.8% were satisfied with the depth of discussion in virtual MDTs and 83.3% felt that the decision-making in diagnosis had not changed following the switch from face-to-face MDTs. About 86% reported to have all essential patient data was available to make decisions and 88.9% were satisfied with the time for discussion of patient issues over virtual platform. Three-fourths of the participants were satisfied (36.1% - highly satisfied; 38.9% - moderately satisfied) with virtual MDTs and 55.6% of them were happy to attend MDTs only by the virtual platform in the future. Regarding future, 77.8% of the participants opined that virtual MDTs would be the future of cancer care and an overwhelming majority (91.7%) felt that the present exercise would serve as a precursor to global MDTs involving specialists from abroad in the future. CONCLUSION: Our study shows that the forced switch to virtual MDTs in sarcoma care following the unprecedented COVID-19 pandemic to be a viable and effective alternative to conventional face-to-face MDTs. With effective and efficient software in place, virtual MDTs would also facilitate in forming extended MDTs in seeking opinions on complex cases from specialists abroad and can expand cancer care globally.


Asunto(s)
Neoplasias Óseas/terapia , Comunicación Interdisciplinaria , Oncología Médica/organización & administración , Neoplasias de los Músculos/terapia , Grupo de Atención al Paciente/organización & administración , Sarcoma/terapia , Telemedicina/organización & administración , Comunicación por Videocoferencia/organización & administración , Actitud del Personal de Salud , Actitud hacia los Computadores , Neoplasias Óseas/diagnóstico , Toma de Decisiones Clínicas , Prestación Integrada de Atención de Salud/organización & administración , Conocimientos, Actitudes y Práctica en Salud , Humanos , Neoplasias de los Músculos/diagnóstico , Sarcoma/diagnóstico , Centros de Atención Terciaria
18.
J Nurs Adm ; 51(2): 67-73, 2021 Feb 01.
Artículo en Inglés | MEDLINE | ID: mdl-33449595

RESUMEN

This article describes one heath system's creation of a new women's health hospital using an innovative model integrating patient care delivery, Lean building design, and Lean integrated project methodology. The article describes a 5-year journey detailing the innovative process that guided the planning and implementation of the new care delivery model, as well as employee and leader roles, employee behavior and engagement, and key insights and lessons learned that will benefit nurse leaders.


Asunto(s)
Centros Comunitarios de Salud/organización & administración , Eficiencia Organizacional , Atención Dirigida al Paciente/organización & administración , Mejoramiento de la Calidad/organización & administración , Niño , Femenino , Humanos , Estudios de Casos Organizacionales , Grupo de Atención al Paciente/organización & administración , Servicios de Salud para Mujeres/organización & administración
19.
J Nurs Adm ; 51(2): 74-80, 2021 Feb 01.
Artículo en Inglés | MEDLINE | ID: mdl-33449596

RESUMEN

BACKGROUND: Healthcare simulation has expanded dramatically; however, little is known about the scope of simulation in acute care hospitals. METHODS: A descriptive, cross-sectional online survey was used. Participants included nurse executives from acute care hospitals in California. RESULTS: Most organizations (96%) used simulation primarily for education, 37% used simulation for health system integration and systems testing, 30% used it for error investigation, 15% used it for research, and 15% used it for patient/family education. CONCLUSIONS: Organizations have a substantial opportunity to increase the scope of simulation beyond education to include systems integration, clinical systems testing, and other translational simulation activities. This targeted focus on patient safety and quality will allow hospitals to improve financial performance and maximize scarce resources.


Asunto(s)
Eficiencia Organizacional/normas , Maniquíes , Personal de Enfermería en Hospital/educación , Grupo de Atención al Paciente/organización & administración , Simulación de Paciente , California , Competencia Clínica , Simulación por Computador , Estudios Transversales , Humanos
20.
J Nurs Adm ; 51(2): 101-105, 2021 Feb 01.
Artículo en Inglés | MEDLINE | ID: mdl-33449600

RESUMEN

Patients' satisfaction with care transitions is low, especially when it comes to understanding their care when discharged home from the hospital. Therefore, a quality improvement effort was initiated with the aim of improving patients' satisfaction with care transitions. Specific goals of the project were to improve communication between healthcare providers and patients, increase patient satisfaction, and enhance patient education by standardizing multidisciplinary discharge planning rounds.


Asunto(s)
Continuidad de la Atención al Paciente/estadística & datos numéricos , Comunicación Interdisciplinaria , Alta del Paciente/normas , Satisfacción del Paciente/estadística & datos numéricos , Transferencia de Pacientes/estadística & datos numéricos , Humanos , Evaluación de Necesidades , Grupo de Atención al Paciente/normas , Mejoramiento de la Calidad
SELECCIÓN DE REFERENCIAS
DETALLE DE LA BÚSQUEDA