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1.
BMJ Open Qual ; 12(2)2023 05.
Article in English | MEDLINE | ID: covidwho-20238915

ABSTRACT

The COVID-19 pandemic resulted in the cessation of approximately 75% of cardiac rehabilitation (CR) programmes worldwide. In March 2020, CR phase II (CRP2) services were stopped in Qatar. Multiple studies had shown safety, effectiveness, reduced cost of delivery and improved participation with hybrid CR. A multidisciplinary team reviewed various alternative models for delivery and decided to implement a hybrid CRP2 exercise programme (HCRP2-EP) to ensure continuation of our patient care. Our aim was to enrol in the HCRP2-EP 70% of all eligible patients by 30 September 2020. Institute for Health Care Improvement's collaborative model was adopted. Multiple plan-do-study-act cycles were used to test change ideas. The outcomes of the project were analysed using standard run chart rules to detect the changes in outcomes over time. This project was implemented from March 2020, and the male patients enrolled between August 2020 and April 2021, with sustained monthly median enrolment above target of 70% throughout. As for our secondary outcome, 75.8% of the male patients who completed HCRP2-EP showed a meaningful change in peak exercise capacity of ≥10% (mean change 17%±6%). There were no major adverse events reported, and the median Patient Satisfaction Score was 96% well above the institutional target of 90%. This shows a well-designed quality improvement programme is an appropriate strategy for implementing HCRP2-EP in a clinical setting, and HCRP2-EP is a feasible, effective and safe intervention in eligible male patients with cardiovascular disease.


Subject(s)
COVID-19 , Cardiac Rehabilitation , Humans , Male , Cardiac Rehabilitation/methods , Pandemics , Quality Improvement , Exercise Therapy
3.
J Family Med Prim Care ; 11(6): 2381-2388, 2022 Jun.
Article in English | MEDLINE | ID: covidwho-1934370

ABSTRACT

Background: Vitamin B12 deficiency leads to a diversity of symptoms and affects many systems. It is often overlooked or sometimes even misdiagnosed in clinical practice. Aims and Objectives: The purposes of this study were to report the prevalence of vitamin B12 deficiency, the spectrum of clinical features and to draw attention to the possibility of rare hidden characteristics. Materials and Methods: This study was a multicenter, retrospective, and prospective conducted at a tertiary care teaching hospital and multispecialty hospital. All cases of vitamin B12 deficiency of either sex or age attending the Medicine Department were enrolled in this study from Aug 2015 to Dec 2020. Parenteral vitamin B12 was given, and cases were evaluated for the response on follow-up for more than three months. Results: Of 220 cases, 52.27% were males. Maximum cases were reported from the age group 50 to 65 years (27.27%) and belonged to urban areas (59.1%). The majority were strict vegetarian (86.36%). Among comorbidities, diabetes (20.91%) followed by malabsorption (10.45%) were most common. The cutaneous manifestations were revealed at 38.18%. The most frequent neurological manifestation was paraesthesia (98.18%). Head heaviness/ache was the most frequent (95%) psychiatric manifestation. Anemia was revealed in 87.73% of cases with 88.64% macrocytosis. Axonal sensorimotor (52.63%) neuropathy was a prevalent finding of NCV study. Conclusions: A high index of clinical suspicion is needed in cases with vague manifestations, especially in the pure vegetarian population. Early recognition can prevent further damage as most of its related disorders are generally reversible with treatment.

4.
British Journal of Healthcare Management ; 28(4):1-9, 2022.
Article in English | CINAHL | ID: covidwho-1789687

ABSTRACT

Background/Aims: The COVID-19 pandemic challenged not only global healthcare systems, but also educational systems, with many large, in-person training programmes being suspended. Instead, virtual learning platforms have been used, with promising results. This study explored the effectiveness of a virtual quality improvement training programme in a healthcare setting. Methods: A 6-week interprofessional virtual quality improvement training programme was developed and delivered to a total of 137 participants across three cohorts. Pre- and post-programme surveys were administered to assess knowledge gained from training. Focus groups were also conducted for more in-depth feedback about the sessions. Information was then collected regarding any quality improvement projects participants had undertaken after completing the training. Results: Mean scores were higher in the post-programme than the pre-programme survey across all knowledge domains (P<0.001, Cohens d=6.63). Over 80% of participants reported that the training improved their understanding of and confidence in undertaking a quality improvement project, and that they would recommend the training to their colleagues. Participants went on to either lead or contribute to a variety of quality improvement projects across a wide range of specialisms. Conclusions: The virtual quality improvement training programme is an effective method of teaching, leading to participants being able to demonstrate competency in quality improvement. This approach to training delivery represents an efficient alternative to in-person training for building capability in frontline healthcare staff.

5.
BMJ Open Quality ; 10(Suppl 2):A14, 2021.
Article in English | ProQuest Central | ID: covidwho-1506051

ABSTRACT

DescriptionA program to scale-up improvements in maternal and newborn health in India confronted the challenges of providing quality improvement training to leaders and front-line clinicians and staff in 38 district hospitals in the state of Bihar, India. Virtual training programs, while not entirely new to the participants, was something that had not been done before on this scale. Results showed exciting improvements in quality improvement understanding and skills, as well as confidence to use and apply new-found knowledge.

6.
Wellcome Open Res ; 5: 184, 2020.
Article in English | MEDLINE | ID: covidwho-808195

ABSTRACT

Background: India first detected SARS-CoV-2, causal agent of COVID-19 in late January 2020, imported from Wuhan, China. From March 2020 onwards, the importation of cases from countries in the rest of the world followed by seeding of local transmission triggered further outbreaks in India. Methods: We used ARTIC protocol-based tiling amplicon sequencing of SARS-CoV-2 (n=104) from different states of India using a combination of MinION and MinIT sequencing from Oxford Nanopore Technology to understand how introduction and local transmission occurred. Results: The analyses revealed multiple introductions of SARS-CoV-2 genomes, including the A2a cluster from Europe and the USA, A3 cluster from Middle East and A4 cluster (haplotype redefined) from Southeast Asia (Indonesia, Thailand and Malaysia) and Central Asia (Kyrgyzstan). The local transmission and persistence of genomes A4, A2a and A3 was also observed in the studied locations. The most prevalent genomes with patterns of variance (confined in a cluster) remain unclassified, and are here proposed as A4-clade based on its divergence within the A cluster. Conclusions: The viral haplotypes may link their persistence to geo-climatic conditions and host response. Multipronged strategies including molecular surveillance based on real-time viral genomic data is of paramount importance for a timely management of the pandemic.

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