Identifying Factors That Impact the Time between Tavr Referral and Intervention

Background Over the past 20 years, transcatheter aortic valve replacement (TAVR) has been safely and rapidly adopted in the U.S., representing a paradigm shift in the management of aortic stenosis. Despite the growing demand for TAVR, little is known about the process from referral to TAVR (time to TAVR). This survey-based study aims to identify factors that impact this process. Methods In 2022, an online survey was emailed to structural heart program coordinators at a large health system (27 programs, n=27) to assess structure-, process-, and patient-related factors that impact the time to TAVR. Descriptive statistics of key care pathway checkpoints, and barriers encountered in the process are reported. Results The response rate was 81% (n=22). Most programs reported taking 3 days or less from the valve clinic referral to 1st contact with pt (n=15, 68%), 2 weeks or less from 1st contact to 1st clinic visit (n=17, 77%), and 2 weeks or less from 1st clinic visit to scheduled TAVR (n=16, 73%). Staffing, scheduling computed tomography, COVID restrictions, authorizations, comorbidities were common barriers impacting the time to TAVR. Conclusion Understanding factors impacting the time to TAVR as well as key metrics of efficiency along this process is critical for responding to its growing demand. [Formula presented]Copyright © 2023 American College of Cardiology Foundation

Enabling in-car location-based experiential learning with Presentria GO

The COVID-19 pandemic has changed how millions around the globe are educated. The 2nd or 3rd waves of the disease have made learning in classrooms unsafe once again. Many schools are forced to send their students home to take online classes under their government's lock-down protocols. For many young learners, engaging with school is a significant part of their well-being, which has been compromised by the extended period of remote learning and low social interaction levels during the pandemic. New and innovative solutions to address learners' needs have been called during this pandemic. The Presentria GO system is an innovative solution that enables students from K-12 to higher education to learn experientially from their cars during a city excursion. Through a survey with 74 educators and a series of expert interviews and focus group discussions, insights into the feasibility of this active learning mode are explored. This paper proposes the concept of 'in-car location-based experiential learning' as one of the methods to engage students during the pandemic and beyond.

Impact of coronavirus disease 2019 on urgent referrals to secondary care otolaryngology: a prospective case series.

OBJECTIVE: As the novel coronavirus disease 2019 changed patient presentation, this study aimed to prospectively identify these changes in a single ENT centre. DESIGN: A seven-week prospective case series was conducted of urgently referred patients from primary care and accident and emergency department. RESULTS: There was a total of 133 referrals. Referral rates fell by 93 per cent over seven weeks, from a mean of 5.4 to 0.4 per day. Reductions were seen in referrals from both primary care (89 per cent) and the accident and emergency department (93 per cent). Presentations of otitis externa and epistaxis fell by 83 per cent, and presentations of glandular fever, tonsillitis and peritonsillar abscess fell by 67 per cent. CONCLUSION: Coronavirus disease 2019 has greatly reduced the number of referrals into secondary care ENT. The cause for this reduction is likely to be due to patients' increased perceived risk of the virus presence in a medical setting. The impact of this reduction is yet to be ascertained, but will likely result in a substantial increase in emergency pressures once the lockdown is lifted and the general public's perception of the coronavirus disease 2019 risk reduces.