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1.
Psychiatry Res ; 311: 114496, 2022 05.
Article in English | MEDLINE | ID: mdl-35306378

ABSTRACT

OBJECTIVE: We aimed to evaluate patient and provider experiences with telemental health (TMH) at an academic outpatient psychiatry department in New York City during the first wave of the COVID-19 pandemic. METHODS: Patients and providers completed online surveys evaluating their experience with TMH during the first wave of the COVID-19 pandemic. Surveys were distributed to 1,178 patients and 287 providers from July 2020 through October 2020. RESULTS: 42.5% of providers and 21% of patients responded to the survey. The majority of patient and provider respondents rated the quality of phone and video visits as "equally good" or "somewhat worse" than in-person visits, while the majority of respondents were "somewhat satisfied" or "very satisfied" with video visits. Patients and providers preferred a hybrid model for future care. Common barriers to TMH included privacy, technical difficulties, and wi-fi access. CONCLUSIONS: Patients and providers appeared willing to exchange some degree of quality for satisfaction with TMH. This study did not demonstrate with statistical significance any specific patient populations that would benefit more or less from TMH, suggesting that TMH may be a successful model for diverse patient populations. Our results suggest that providers, payors, and regulators should facilitate hybrid care delivery models that incorporate TMH beyond the pandemic.


Subject(s)
COVID-19 , Telemedicine , Academic Medical Centers , Humans , New York City , Pandemics , Telemedicine/methods
2.
Curr Psychiatry Rep ; 21(11): 114, 2019 11 07.
Article in English | MEDLINE | ID: mdl-31701245

ABSTRACT

PURPOSE OF REVIEW: Despite being recognized as a first-line treatment for bipolar disorder, there is still inconsistent use of lithium in perinatal populations. This article will review data regarding lithium use during the peripartum and provide management recommendations for general psychiatric clinicians. RECENT FINDINGS: In contrast to prior data, recent studies indicate that lithium use in pregnancy is associated with either no increased malformations risk or a small increase in risk for cardiac malformations including Ebstein's anomaly. Limited data also show no significant effect on obstetric or neurodevelopmental outcomes. Data regarding infant lithium exposure via breastmilk remains limited. Lithium is currently under-prescribed and is an important treatment for women with bipolar disorder in pregnancy and the postpartum. Clinicians must weigh the risk of lithium treatment versus the risk of withholding or changing lithium treatment when managing bipolar disorder in this population.


Subject(s)
Bipolar Disorder/drug therapy , Lithium Compounds/therapeutic use , Lithium/therapeutic use , Postpartum Period/drug effects , Pregnancy Complications/psychology , Female , Humans , Infant , Lithium/adverse effects , Lithium Compounds/adverse effects , Postpartum Period/psychology , Pregnancy , Pregnancy Complications/drug therapy , Risk Assessment , Treatment Outcome
3.
Am J Infect Control ; 47(9): 1102-1106, 2019 09.
Article in English | MEDLINE | ID: mdl-31005345

ABSTRACT

BACKGROUND: No single strategy is more effective than proper hand hygiene (HH) in reducing the spread of nosocomial infections. Unfortunately, health care worker compliance with HH is imperfect. We sought to improve HH compliance using an electronic hand hygiene monitoring system (EHHMS) in 2 units to collect unbiased data and provide feedback. METHODS: In this prospective, quasi-experimental study, the Hyginex EHHMS was installed in 2 units at Tufts Medical Center. Ninety-one bracelets were assigned, and electronic data were collected over 8 months. Human observations continued. We compared HH compliance as measured by human observation before, during, and after EHHMS implementation. Pre- and post-implementation surveys were distributed to staff. RESULTS: The number of electronically captured HH compliance observations was small due to infrequent bracelet use after month 2 of the intervention. HH compliance, as determined by human observation, increased by an average of 1.3 percentage points per month (P = .0005). Survey responses revealed negative attitudes about the EHHMS before and after its implementation. CONCLUSIONS: Despite poor EHHMS participation and negative attitudes toward its implementation, HH compliance, as measured by human observation, significantly improved. Hospitals considering implementing an EHHMS should look to refine the intervention to encourage health care worker participation.


Subject(s)
Behavior Observation Techniques/methods , Electronics/methods , Guideline Adherence/statistics & numerical data , Hand Hygiene/statistics & numerical data , Infection Control/methods , Boston , Cross Infection/prevention & control , Disease Transmission, Infectious/prevention & control , Hand Hygiene/methods , Hospitals, University , Humans , Non-Randomized Controlled Trials as Topic , Prospective Studies
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