ABSTRACT
BACKGROUND: Healthwatch England estimated emergency readmissions have risen by 22.8% between 2012-13 and 2016-17. Some emergency readmissions could be avoided by providing patients with urgent out of hospital medical care or support. Sovereign Health Network (SHN) comprises of three GP practices, with a combined population of 38,000. OBJECTIVE: We will decrease the number of SHN patients readmitted within 30 days of discharge from Portsmouth Hospitals Trust following a non-elective admission (excluding Emergency Department attendance) by 40-60% by July 2020. METHODS: Four Plan, Do, Study, Act (PDSA) cycles were used to test the administrative and clinical processes. Our Advanced Nurse Practitioner reviewed all discharge summaries, added alerts to records, and proactively contacted patients either by text, telephone or home visit. RESULTS: 92 patients aged 23 days to 97 years were admitted onto the recent discharge scheme. Half of discharge summaries were received on the day of discharge, whilst 29% of discharge summaries were received more than 24 hours post-discharge, and one was received 11 days post-discharge. Following our interventions, there were 55% less than expected readmissions during the same time period. CONCLUSION: To allow proactive interventions to be instigated in a timely manner, discharge summaries need to be received promptly. The average readmission length of stay following a non-elective admission is seven days. Our proactive interventions saved approximately 102.9 bed days, with potential savings of 1,775 bed days over a year. We feel the results from our model are promising and could be replicated by other Primary Care Networks to result in larger savings in bed days.
Subject(s)
Patient Discharge , Patient Readmission , Humans , Length of Stay , Aftercare , Hospitals , Retrospective Studies , Emergency Service, HospitalABSTRACT
Introduction: Coronavirus Disease-2019 (COVID-19) pandemic exposed the health workforce to an unprecedented occupational hazard. While taking care of patients they always had to be conscious simultaneously for safeguarding themselves and their family members against the highly infectious virus. In West Bengal, cases were first reported in the last week of March-2020 and reached the peak around October-2020 in the first wave, once the lockdown was lifted. During the initial months, the staggering number of cases, prevailing uncertainty over case management, and untimely demise of colleagues and relatives, took their toll on the physical and mental health of doctors, paramedics, or support staff, both in the government and private sectors. Aim(s): To measure perceived stress, resilience and psychological well-being of healthcare providers using standard psychometric tools. Material(s) and Method(s): This was a cross-sectional observational study carried out among healthcare workers in hospitals located in West Bengal, India. A self-administered questionnaire was circulated through a digital platform between June-November 2020. The questionnaire was designed using Perceived Stress Scale (PSS-10), Kessler-6 (K6), and Brief Resilient Coping Scale (BRCS) to assess perceived stress, psychiatric morbidity, and resilience of the person. It had three parts, one to capture socio-demographic details of the participants including age, sex, marital status, occupation, family history of psychiatric morbidity, place of stay etc. Second part consisted of psychometric scales and third was designed to capture the views of participants on the coping strategies. Calculated sample size was 189. Result(s): Based on standard cut-off values, it was found that 65.6% subjects were under moderate or severe stress;56.6% had compromised mental well-being and 64% were not coping well with the pandemic situation. PSS were significantly poor for females(p-value<0.001),single(p-value<0.001)andthosewithout history of psychiatric morbidity (p-value <0.001) and low resilient copers (p<0.0001). Mental well-being was compromised more among married (p-value=0.01), doctors (p-value=0.008), aged <40 years (p-value=0.003), high resilient copers (p-value=0.02). Popular means of stress reliever were music and yoga/exercise. Correct and updated knowledge on disease transmission, availability of personal protective equipment, pursuing hobbies like music and gardening were few suggested measures to improve coping with stress associated with patient care. Conclusion(s): The study revealed that majority of the health workers experienced moderate to heavy degree of stress and compromised psychological well-being during the first wave of pandemic. Relationship of stress and psychological wellbeing with resilience and socio-demographic variables was not always linear. Copyright © 2022 Journal of Clinical and Diagnostic Research. All rights reserved.
ABSTRACT
The outbreak of COVID-19 hit the world with an incomparable magnitude and introduced new challenges in the diagnosis and treatment of patients. Personal interactions have suddenly become dangerous which can be reduced by the use of digital technology in healthcare. Towards this, we have developed a low-cost remote vital sign monitoring system (VSM) that can be used at hospitals as well as at home for continuous and long-term monitoring of different clinical status, and provide extended support to the vulnerable patients. The proposed VSM has been designed with four layers: sensing layer, data processing layer, networking layer, and applications layer. It comes with three units: a wrist unit, a bedside monitor and a web-based graphical user interface (GUI) accessible by the nurse, physician or attendants remotely from anywhere. The effectiveness of measurement, transmission, and remote monitoring has been demonstrated by experiments. The system is designed with open source and low-cost hardware devices to ensure that it can be afforded and implemented in low resource settings of the developing countries. The proposed system can provide an effective way of delivering care to more patients while protecting everyone involved from infection.