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Journal of Wound, Ostomy, and...Despite recent advances in intermittent catheter features, evidence guiding how to best educate patients when beginning and continuing a program of intermittent... (Review)
Review
Despite recent advances in intermittent catheter features, evidence guiding how to best educate patients when beginning and continuing a program of intermittent catheterization remains sparse. To address this gap and guide best practice, a scoping review was conducted and a consensus panel of clinicians and researchers with expertise in intermittent catheterization was convened in person during December 2022 in Austin, Texas, to develop evidence and consensus-based statements guiding instruction of patients beginning intermittent self or assisted catheterization. This article describes the 15 consensus-based statements that can be used to guide best practice in patient education on intermittent catheterization.
Topics: Humans; Patient Education as Topic; Urinary Catheterization; Consensus; Patients
PubMed: 37713350
DOI: 10.1097/WON.0000000000001013 -
Radiologie (Heidelberg, Germany) Sep 2023Patient-centered radiology and employee-centered radiology are being increasingly discussed as an extension of the established structure- and process-oriented management... (Review)
Review
BACKGROUND
Patient-centered radiology and employee-centered radiology are being increasingly discussed as an extension of the established structure- and process-oriented management perspective. Concerning potential conflicts, it is unclear if and how these approaches should best be implemented in a radiology department.
OBJECTIVE
The aim of this narrative review is to identify and critically correlate underlying characteristics of patient-centered and employee-centered approaches including their similarities, conflicts, and synergies as applicable to the radiological work environment.
MATERIALS AND METHODS
Based on a literature search using PubMed, Scopus, Web of Science, and Google Scholar, the current body of knowledge regarding patient- and employee-centered radiology is presented.
RESULTS
Patient- and employee-centered radiology focus on the individual needs of patients and employees, respectively, and promise to improve patient satisfaction, healthcare outcomes, and organizational performance. Conflicts result from an increased organizational complexity and the concurrent utilization of limited resources, such as time, money, and staff. Overall, however, synergies outweigh the potential conflicts.
CONCLUSIONS
Successful implementation of patient- and employee-centered approaches in radiology requires a human-centered leadership approach and an overarching strategy with the execution of specific interventions in the processes. We provide specific recommendations to this effect.
Topics: Humans; Patients; Delivery of Health Care; Health Facilities; Radiology; Patient-Centered Care
PubMed: 37566129
DOI: 10.1007/s00117-023-01195-8 -
Radiography (London, England : 1995) Aug 2023This study investigated how patients expected and experienced to be put first and cared for in diagnostic imaging settings and how putting the patient first was...
INTRODUCTION
This study investigated how patients expected and experienced to be put first and cared for in diagnostic imaging settings and how putting the patient first was operationalized in practice.
METHODS
A qualitative field study was conducted in two Danish hospitals to investigate patients' expectations and experiences of care and involvement during CT examinations. Data collection methods included semi-structured interviews and participant observations of five examination cases. Three Computed Tomography (CT) guided lung biopsy intervention studies and two conventional CT studies of the chest of patients being investigated for lung cancer in Fast Track Cancer Referral Programs (FTCRP) were included.
RESULTS
Patients reported low expectations of receiving care and being involved during examinations. Perceptions of receiving care predominantly consisted of being received in a kind, personalized manner. Expectations of involvement in the procedure were reported in terms of readiness to do as they were told, complying with requests put to each patient. Concepts of care and involvement were challenged in their formal meanings and found to be entangled in complex interactions within sociotechnical boundaries.
CONCLUSION
Patient's expectations of receiving care and being involved in the diagnostic imaging procedures, were expressed in noncommittal terms, and were overshadowed by patients' focus on getting through the examination, in order to get an answer to their tentative diagnose. The concepts of care and patient involvement were negotiated and reconceptualized within the sociotechnical framework of the diagnostic imaging situation of the individual patient. The concept of "tinkering" is suggested as a means of understanding how patientcare is performed during diagnostic imaging procedures.
IMPLICATIONS FOR PRACTICE
Issues were identified that may help professionals to put "the patient first", thus, improving patient centered care.
Topics: Humans; Patient Participation; Motivation; Patients; Qualitative Research; Tomography, X-Ray Computed
PubMed: 37524036
DOI: 10.1016/j.radi.2023.07.005 -
Revue Medicale Suisse Sep 2023Asthmatic exacerbations (AEs) are a frequent reason for emergency department visits. Management should be guided by the severity of the attack but should also focus on...
Asthmatic exacerbations (AEs) are a frequent reason for emergency department visits. Management should be guided by the severity of the attack but should also focus on patient education and prevention of future exacerbations. This article summarizes current recommendations for the management of both simple and life-threatening AE. When the clinical evolution is favorable, and the patient no longer presents any criteria of severity or risk factors for decompensation, a return home can be considered, with appropriate treatment and the organization of outpatient follow-up. However, if the patient's prognosis is likely to be engaged, transfer to an intensive care unit should not be delayed, to ensure optimal care.
Topics: Humans; Adult; Asthma; Emergency Service, Hospital; Intensive Care Units; Outpatients; Risk Factors
PubMed: 37671761
DOI: 10.53738/REVMED.2023.19.840.1606 -
Journal of Psychiatric Practice Sep 2023Patients may present with manic symptoms in medical settings such as emergency rooms and on inpatient medical floors, leading to psychiatric consultation to try to...
Patients may present with manic symptoms in medical settings such as emergency rooms and on inpatient medical floors, leading to psychiatric consultation to try to determine the etiology of the symptoms. It is crucial to clarify whether the mania is secondary to a medical illness or whether the patient's symptoms are from a primary bipolar disorder. In this issue, we publish 2 case reports of patients presenting with manic symptoms in medical settings. The first case involves polymicrogyria in the frontal lobe of the brain as a cause of secondary mania. The second case involves a patient who was previously diagnosed with bipolar disorder and subsequently developed symptoms of Behçet's disease. In this case, it appears likely that the bipolar disorder was primary, and that the Behçet disease and the bipolar disorder may have exacerbated each other. Given the complexities involved in assessing and treating patients, especially in acute or emergency settings, it is important for primary medical and psychiatric providers to collaborate and communicate well in assuring that they obtain a thorough history of their patients' symptoms and that patients receive a comprehensive medical evaluation before psychiatric treatment is started.
Topics: Humans; Mania; Bipolar Disorder; Brain; Inpatients; Emergency Service, Hospital
PubMed: 37678372
DOI: 10.1097/PRA.0000000000000731 -
European Radiology Jul 2024Creating a patient-centered experience is becoming increasingly important for radiology departments around the world. The goal of patient-centered radiology is to ensure... (Review)
Review
Creating a patient-centered experience is becoming increasingly important for radiology departments around the world. The goal of patient-centered radiology is to ensure that radiology services are sensitive to patients' needs and desires. This article provides a framework for addressing the patient's experience by dividing their imaging journey into three distinct time periods: pre-exam, day of exam, and post-exam. Each time period has aspects that can contribute to patient anxiety. Although there are components of the patient journey that are common in all regions of the world, there are also unique features that vary by location. This paper highlights innovative solutions from different parts of the world that have been introduced in each of these time periods to create a more patient-centered experience. CLINICAL RELEVANCE STATEMENT: Adopting innovative solutions that help patients understand their imaging journey and decrease their anxiety about undergoing an imaging examination are important steps in creating a patient centered imaging experience. KEY POINTS: • Patients often experience anxiety during their imaging journey and decreasing this anxiety is an important component of patient centered imaging. • The patient imaging journey can be divided into three distinct time periods: pre-exam, day of exam, and post-exam. • Although components of the imaging journey are common, there are local differences in different regions of the world that need to be considered when constructing a patient centered experience.
Topics: Patient-Centered Care; Humans; Anxiety; Diagnostic Imaging; Radiology; Ambulatory Care; Radiology Department, Hospital; Outpatients; Patient Satisfaction
PubMed: 38047974
DOI: 10.1007/s00330-023-10370-3 -
BMC Health Services Research Aug 2023As outpatient chemotherapy treatment increases, cancer patients receiving chemotherapy spend more time at home. In addition, since the types of chemotherapy are... (Review)
Review
BACKGROUND
As outpatient chemotherapy treatment increases, cancer patients receiving chemotherapy spend more time at home. In addition, since the types of chemotherapy are gradually expanding, it will be essential to prepare patient self-management strategies for various chemotherapy-related side effects. This study aimed to develop a platform (called Smart Cancer Care) to implement a chemotherapy side effect management program and to evaluate its feasibility.
METHODS
Smart Cancer Care comprises an application for patients and a dashboard for medical staff. Thirty-two symptoms to be managed using Smart Cancer Care were summarized through a literature review and Delphi. Management guidelines were developed based on the severity of each symptom (3 stages), and installed in Smart Cancer Care according to the Common Terminology Criteria for Adverse Events (CTCAE) v5.0 guidelines. To evaluate the feasibility of the developed application and medical dashboard, cancer patients and cancer treatment medical staff used Smart Cancer Care for 2 to 3 weeks and subsequently reported the experience of using them.
RESULTS
The patient application provided a list of symptoms according to the cancer type and anticancer drug enabling presence and severity of each symptom to be evaluated. Patients received management guidelines for symptoms based on the symptom evaluation results. On the medical staff dashboard, administrators and authorized medical personnel could access and assess information regarding side effects and symptom severity submitted by the patient. The feasibility and usefulness of Smart Cancer Care were confirmed through a pilot test targeting 30 patients and 24 chemotherapy-related medical staff. For patients, the evaluation score for the "The program will be helpful when seeing medical staff" item was the highest. For medical staff, the score for the "By checking the patient's symptoms using the program, it helps to take appropriate measures for the patient" item was the highest. Although minor corrections were raised, most patients and medical staff expected that Smart Cancer Care would help their treatment.
CONCLUSIONS
The configuration of the application and dashboard of Smart Cancer Care detailed in this study could be used for the development of a widely accepted platform to implement a chemotherapy side effect management program.
Topics: Humans; Pilot Projects; Drug-Related Side Effects and Adverse Reactions; Outpatients; Self-Management; Administrative Personnel; Neoplasms
PubMed: 37644519
DOI: 10.1186/s12913-023-09871-0 -
Health Care Management Science Sep 2023Patient no-shows are a major source of uncertainty for outpatient clinics. A common approach to hedge against the effect of no-shows is to overbook. The trade-off...
Patient no-shows are a major source of uncertainty for outpatient clinics. A common approach to hedge against the effect of no-shows is to overbook. The trade-off between patient's waiting costs and provider idling/overtime costs determines the optimal level of overbooking. Existing work on appointment scheduling assumes that appointment times cannot be updated once they have been assigned. However, advances in communication technology and the adoption of online (as opposed to in-person) appointments make it possible for appointments to be flexible. In this paper, we describe an intraday dynamic rescheduling model that adjusts upcoming appointments based on observed no-shows. We formulate the problem as a Markov Decision Process in order to compute the optimal pre-day schedule and the optimal policy to update the schedule for every scenario of no-shows. We also propose an alternative formulation based on the idea of 'atomic' actions that allows us to apply a shortest path algorithm to solve for the optimal policy more efficiently. Based on a numerical study using parameter estimates from existing literature, we find that intraday dynamic rescheduling can reduce expected cost by 15% compared to static scheduling.
Topics: Humans; No-Show Patients; Appointments and Schedules; Ambulatory Care Facilities; Markov Chains; Time Factors
PubMed: 37428303
DOI: 10.1007/s10729-023-09643-6 -
Journal of Public Health Policy Dec 2023Patient surgical registries are essential tools for public health specialists, creating research opportunities through linkage of registry data with healthcare outcomes.... (Review)
Review
Patient surgical registries are essential tools for public health specialists, creating research opportunities through linkage of registry data with healthcare outcomes. However, little is known regarding data error sources in the management of surgical registries. In June 2022, we undertook a scoping study of the empirical literature including publications selected from the PUBMED and EMBASE databases. We selected 48 studies focussing on shared experiences centred around developing surgical patient registries. We identified seven types of data specific challenges, grouped in three categories- data capture, data analysis and result dissemination. Most studies underlined the risk for a high volume of missing data, non-uniform geographic representation, inclusion biases, inappropriate coding, as well as variations in analysis reporting and limitations related to the statistical analysis. Finally, to expand data usability, we discussed cost-effective ways of addressing these limitations, by citing aspects from the protocols followed by established exemplary registries.
Topics: Humans; Registries; Surgical Procedures, Operative; Patients
PubMed: 37726394
DOI: 10.1057/s41271-023-00442-5 -
Pediatric Emergency Care Jul 2023The emergency department can be a particularly challenging environment for the care of pediatric patients presenting with acute agitation. Agitation is a behavioral... (Review)
Review
The emergency department can be a particularly challenging environment for the care of pediatric patients presenting with acute agitation. Agitation is a behavioral emergency requiring prompt intervention. Timely recognition of agitation and proactive implementation of de-escalation strategies are critical for safe and effective management of agitation, as well as prevention of recurrent episodes. This article reviews the definition of agitation, explores the domains of verbal de-escalation, and considers multidisciplinary management strategies for children with acute agitation.
Topics: Humans; Child; Behavior Therapy; Emergency Service, Hospital; Patients
PubMed: 37383009
DOI: 10.1097/PEC.0000000000002989