To see the other types of publications on this topic, follow the link: Consultation responses.
Journal articles on the topic 'Consultation responses'
Create a spot-on reference in APA, MLA, Chicago, Harvard, and other styles
Consult the top 50 journal articles for your research on the topic 'Consultation responses.'
Next to every source in the list of references, there is an 'Add to bibliography' button. Press on it, and we will generate automatically the bibliographic reference to the chosen work in the citation style you need: APA, MLA, Harvard, Chicago, Vancouver, etc.
You can also download the full text of the academic publication as pdf and read online its abstract whenever available in the metadata.
Browse journal articles on a wide variety of disciplines and organise your bibliography correctly.
1
Babaniamansour, Sepideh. "The Quality of Medical Consultations in a Teaching Hospital: A Cross-Sectional Study." Journal of Biomedical Research & Environmental Sciences 2, no. 5 (May 2021): 392–98. http://dx.doi.org/10.37871/jbres1247.
Full textAbstract:
Background and objectives: Medical consultations became undeniable elements for the quality of health care and training of medical residence. This study aimed to assess the quality of performed consultations. Methods: This retrospective cross-sectional study at Shohadaye Tajrish hospital, affiliated to Shahid Beheshti University of Medical Sciences, in Tehran, Iran between 20th April 2018 and 4th May 2019. The reported items and quality score of medical consultation requests and responses between emergency and non-emergency consultations and between the faculty members and medical residents were assessed by SPSS version 21.0. Results: Among 431 medical consultations, most were non-emergency, requested by residents, and responded to by faculty members. The quality of consultations requested (p < 0.001) or responded (p < 0.001) by faculty members was higher than by medical residents. Higher year residents performed higher quality consultation requests (p = 0.008) and responses (p < 0.001). The quality score of consultation requests (p = 0.51) and responses (p = 0.1) had no significant difference between types of consultation. Conclusion: Underreported items of consultation impressed its quality. Faculty members and higher-year residents performed higher quality consultations.
2
Claoué, Charles. "Additional Consultation Responses." Journal of Cataract & Refractive Surgery 22, no. 6 (July 1996): 654. http://dx.doi.org/10.1016/s0886-3350(96)80295-1.
Full text
3
Dixon, William S. "Additional Consultation Responses." Journal of Cataract & Refractive Surgery 22, no. 6 (July 1996): 654–55. http://dx.doi.org/10.1016/s0886-3350(96)80296-3.
Full text
4
Ellis, Mark F., John Bolger, Bernhard Steinmetz, and Charles Claoué. "Responses to Consultation Section." Journal of Cataract & Refractive Surgery 24, no. 4 (April 1998): 430–32. http://dx.doi.org/10.1016/s0886-3350(98)80273-3.
Full text
5
Newland, Rita. "The SCPHN apprentice: Consultation responses." Journal of Health Visiting 6, no. 10 (October 2, 2018): 473. http://dx.doi.org/10.12968/johv.2018.6.10.473.
Full text
6
Bradley, Doreen R., Angie Oehrli, Soo Young Rieh, Elizabeth Hanley, and Brian S. Matzke. "Advancing the Reference Narrative: Assessing Student Learning in Research Consultations." Evidence Based Library and Information Practice 15, no. 1 (March 12, 2020): 4–19. http://dx.doi.org/10.18438/eblip29634.
Full textAbstract:
Abstract
Objective – As reference services continue to evolve, libraries must make evidence based decisions about their services. This study seeks to determine the value of reference services in relation to student learning acquired during research consultations, by soliciting students’ and librarians’ perceptions of consultation success and examining the degree of alignment between them.
Methods – The alignment of students’ learning outcomes (reported skills and knowledge acquired) with librarians’ expectations for student learning during consultations was assessed. An online questionnaire was conducted to gather responses from students who had sought consultation services; 20 students participated. In-person interviews took place with eight librarians who had provided these consultations. The online questionnaire for students included questions about students’ assessments of their self-identified learning goals through consultation with a librarian and their success at applying the knowledge and skills gained. Librarian interviews elicited responses about students’ prior research experience, librarians’ objectives for student learning, librarians’ perceptions of student learning outcomes, and perceived consultation success. The responses of both the students and the librarians were coded, matched, and compared.
Results – Students and librarians both considered the consultation process to be successful in advancing learning objectives and research skills. All students reported that the consultations met their expectations, and most reported that the skills acquired were applicable to their projects and significantly improved the quality of their work. Librarians expressed confidence that students had gained competency in the following skill sets: finding sources, search strategy development, topic exploration, specific tool use, and library organization and access. A high degree of alignment was observed in the identification by both students and librarians of “finding sources” as the skill set most in need of enhancement or assistance, while some disparity was noted in the ranking of “search strategy development,” which librarians ranked second and students ranked last.
Conclusion – The data demonstrate that both students and librarians perceived individual research consultations as an effective means to meet student learning expectations. Study findings suggest that as reference models continue to change and reference desk usage declines, research consultations remain a valuable element in a library’s service model and an efficient use of human resources.
7
Rasmussen, Anne. "Participation in Written Government Consultations in Denmark and the UK: System and Actor-level Effects." Government and Opposition 50, no. 2 (August 7, 2014): 271–99. http://dx.doi.org/10.1017/gov.2014.16.
Full textAbstract:
Despite the proliferation of instruments of public consultation in liberal democracies, little is known of how the design and use of these instruments affect stakeholder participation in practice. The article examines participation in written government consultations in an analysis of approximately 5,000 responses to consultations in Denmark and the UK in the first half of 2008. It shows that participation is highly conditional upon system- and actor-level characteristics in practice. Our findings indicate that, even if liberal democracies have adopted similar procedures for actor consultation in the last decades, the design and application of crucial rules vary considerably between systems. They emphasize how the conduct of consultation is heavily conditioned by the design of these processes, which is in turn constrained by the historical legacy of state–society structures of the system in question.
8
Brink-Muinen, Atie Van Den, and Wilma Caris-Verhallen. "Doctors' responses to patients' concerns: testing the use of sequential analysis." Epidemiologia e Psichiatria Sociale 12, no. 2 (June 2003): 92–97. http://dx.doi.org/10.1017/s1121189x0000614x.
Full textAbstract:
SUMMARYAims – The aim of this small scale study was to explore interaction sequences during the medical consultation. Specific attention was paid to how doctors responded to patient's concerns and worries. Empathic behaviours ( e.g. concern, partnership, legitimising) and facilitating behaviours (e.g. paraphrasing, agreement) were considered as an adequate response to a patient's concern. Methods – Nine consultations of nine different GPs were randomly selected from a sample of 1600 videotaped doctor-patient consultations, that were all rated with the Roter Interaction Analysis System. Each consultation contained at least 9 utterances of patient's concern. It was investigated how doctors respond within five lags of utterances after a patient's concern. Results – The results showed that doctors more often responded to a patient's concern in a facilitative way than in an empathic way. When an empathic response was given, it appeared mostly during the first utterance after the patient expressed a concern. Conclusions – The findings indicate that sequential analysis is appropriate to investigate a health care provider's specific style of responding. Based on the problems emerged during the sequential analysis, further exploration of the method is recommended.Declaration of Interest: none.
9
KAPUR, N., I. HUNT, M. LUNT, J. McBETH, F. CREED, and G. MACFARLANE. "Psychosocial and illness related predictors of consultation rates in primary care – a cohort study." Psychological Medicine 34, no. 4 (April 21, 2004): 719–28. http://dx.doi.org/10.1017/s0033291703001223.
Full textAbstract:
Background. Despite extensive research, the reasons why patients consult their doctors are unclear. The aim of the current study was to identify the psychosocial and illness related factors that independently predicted primary care consultation over a 5-year period.Method. We carried out a prospective, population-based cohort study with three waves of data collection by postal questionnaire in one general practice in Greater Manchester (UK). Consultation data were sought from primary care records on a random subsample of 800 adult patients. The main outcome measure was the number of consultations (including surgery and home visits) over the 5 years of the study as determined by raters blind to questionnaire responses. Questionnaire measures included the 12-item version of the General Health Questionnaire, the Illness Attitude Scales, a somatic symptom scale, a fatigue scale, a functional assessment of disability.Results. Consultation data were obtained on 738 patients (92% of selected subjects), who accounted for 12182 consultations. Negative illness attitudes, the presence of physical and psychiatric disorder, health anxiety, changes in psychological distress, reported physical symptoms and demographic factors such as age and sex were independently associated with consultation over a 5-year period. These variables together accounted for a difference of ten consultations per year between groups.Conclusion. Consultation in primary care is a complex behaviour with a complex aetiology. Terms such as ‘frequent attenders’ may be less helpful than recognizing a number of dimensions that operate across the whole spectrum of consultation frequency. Future research should consider the wider context of consultation.
10
Darby, Padraig L., and Peter J. Schmidt. "Psychiatric Consultations in Rheumatology: A Review of 100 Cases." Canadian Journal of Psychiatry 33, no. 4 (May 1988): 290–93. http://dx.doi.org/10.1177/070674378803300411.
Full textAbstract:
Consultation-liaison psychiatry has contributed much to our understanding of the psychological complications of physical illness, both in general responses to illness and in particular problems related to specific diseases. We reviewed 100 psychiatric consultations from a specialized rheumatology unit. Eighty percent of the consultations consisted of patients with systemic lupus erythematosus (36%), rheumatoid arthritis (29%), and fibrositis (15%). The majority of S.L.E. patients had organic brain syndromes related to central nervous system involvement or corticosteroids, while the majority of rheumatoid arthritis patients had a depressive diagnosis. Fibrositis patients showed no specific psychiatric diagnosis. Some future areas of research for consultation-liaison psychiatry in this area are suggested.
11
Bartlett, Virginia L., and Stuart G. Finder. "Lessons learned from nurses’ requests for ethics consultation: Why did they call and what did they value?" Nursing Ethics 25, no. 5 (August 11, 2016): 601–17. http://dx.doi.org/10.1177/0969733016660879.
Full textAbstract:
Background: An ongoing challenge for clinical ethics consultation is learning how colleagues in other healthcare professions understand, make use of, and evaluate clinical ethics consultation services. Aim: In pursuing such knowledge as part of clinical ethics consultation service quality assessment, clinical ethics consultation services can learn important information about the issues and concerns that prompt colleagues to request ethics consultation. Such knowledge allows for greater outreach, education, and responsiveness by clinical ethics consultation services to the concerns of clinician colleagues. Design: This quality assessment project explores consultation requests and follow-up questionnaire responses voluntarily submitted from nurses who requested clinical ethics consultation. We present qualitative data analyzed using content analysis and constant comparison methods to identify key concerns that prompted requests as well as common themes among nurse requestors’ evaluations of what was most important in clinical ethics consultations. Participants and context: A total of 41 nurses requesting clinical ethics consultation and 15 who returned the follow-up questionnaire. Ethical considerations: Our Office of Research Compliance and Quality Improvement determined that our project was not considered human subjects research and so did not require institutional review board approval or exemption. However, efforts were made to avoid any sense of coercion and all data were de-identified prior to analysis. Findings: Our analysis revealed six main categories of issues that prompted nurses’ requests for ethics consultation, as well as unifying themes around nurses’ experiences, advocacy, and family support while caring for patients in the intersections of patients, families, and physicians. Discussion: The insights gained from analyzing nurses’ requests for and responses to clinical ethics consultation may serve as a resource for clinical ethics consultation services seeking to identify, respond to, and educate regarding issues of importance to nurse colleagues and may be a resource for nursing administrators and leadership seeking to identify and address common ethical issues nurses face. Conclusion: Ongoing work on clinical ethics consultation service quality improvement and engagement with our nursing colleagues about their concerns prompting—and their evaluations of—clinical ethics consultation are necessary.
12
Albury, Charlotte, Elizabeth Stokoe, Sue Ziebland, Helena Webb, and Paul Aveyard. "GP-delivered brief weight loss interventions: a cohort study of patient responses and subsequent actions, using conversation analysis in UK primary care." British Journal of General Practice 68, no. 674 (August 13, 2018): e646-e653. http://dx.doi.org/10.3399/bjgp18x698405.
Full textAbstract:
BackgroundGuidelines encourage GPs to make brief opportunistic interventions to support weight loss. However, GPs fear that starting these discussions will lead to lengthy consultations. Recognising that patients are committed to take action could allow GPs to shorten brief interventions.AimTo examine which patient responses indicated commitment to action, and the time saved if these had been recognised and the consultation closed sooner.Design and settingA mixed-method cohort study of UK primary care patients participating in a trial of opportunistic weight management interventions.MethodConversation analysis was applied to 226 consultation audiorecordings to identify types of responses from patients that indicated that an offer of referral to weight management was well received. Odds ratios (OR) were calculated to examine associations between response types and likelihood of weight management programme attendance.ResultsAffirmative responses, for example ‘yes’, displayed no conversational evidence that the referral was well received and showed no association with attendance: ‘yes’ (OR 1.2, 95% confidence interval [CI] = 0.37 to 3.95, P = 0.97). However, ‘oh’-prefaced responses and marked positive responses, for example ‘lovely’, showed conversational evidence of enthusiasm and were associated with higher odds of commercial weight management service attendance. Recognising these could have saved doctors a mean of 31 seconds per consultation.ConclusionWhen doctors make brief opportunistic interventions that incorporate the offer of help, ‘oh’-prefaced or marked positive responses indicate enthusiastic acceptance of the offer and a higher likelihood of take-up. Recognising these responses and moving swiftly to facilitate patient action would shorten the brief intervention in many cases.
13
Reiter, Lauren, and Carmen Cole. "Beyond Face Value: Evaluating Research Consultations from the Student Perspective." Reference & User Services Quarterly 59, no. 1 (December 11, 2019): 23. http://dx.doi.org/10.5860/rusq.59.1.7222.
Full textAbstract:
In this study, the authors examined the value of research consultations, an important component of reference services. Previous research explored the sustainability and scalability of a large-scale research consultation project from the librarian perspective. Through survey responses from the perspectives of more than 1,500 students, the authors gathered evidence on the impact of research consultations on student confidence and their perceptions of the approachability and helpfulness of library personnel.
14
Mold, Freda, Jane Hendy, Yi-Ling Lai, and Simon de Lusignan. "Electronic Consultation in Primary Care Between Providers and Patients: Systematic Review." JMIR Medical Informatics 7, no. 4 (December 3, 2019): e13042. http://dx.doi.org/10.2196/13042.
Full textAbstract:
Background Governments and health care providers are keen to find innovative ways to deliver care more efficiently. Interest in electronic consultation (e-consultation) has grown, but the evidence of benefit is uncertain. Objective This study aimed to assess the evidence of delivering e-consultation using secure email and messaging or video links in primary care. Methods A systematic review was conducted on the use and application of e-consultations in primary care. We searched 7 international databases (MEDLINE, EMBASE, CINAHL, Cochrane Library, PsycINFO, EconLit, and Web of Science; 1999-2017), identifying 52 relevant studies. Papers were screened against a detailed inclusion and exclusion criteria. Independent dual data extraction was conducted and assessed for quality. The resulting evidence was synthesized using thematic analysis. Results This review included 57 studies from a range of countries, mainly the United States (n=30) and the United Kingdom (n=13). There were disparities in uptake and utilization toward more use by younger, employed adults. Patient responses to e-consultation were mixed. Patients reported satisfaction with services and improved self-care, communication, and engagement with clinicians. Evidence for the acceptability and ease of use was strong, especially for those with long-term conditions and patients located in remote regions. However, patients were concerned about the privacy and security of their data. For primary health care staff, e-consultation delivers challenges around time management, having the correct technological infrastructure, whether it offers a comparable standard of clinical quality, and whether it improves health outcomes. Conclusions E-consultations may improve aspects of care delivery, but the small scale of many of the studies and low adoption rates leave unanswered questions about usage, quality, cost, and sustainability. We need to improve e-consultation implementation, demonstrate how e-consultations will not increase disparities in access, provide better reassurance to patients about privacy, and incorporate e-consultation as part of a manageable clinical workflow.
15
Finder, Stuart G., and Virginia L. Bartlett. "Discovering What Matters: Interrogating Clinician Responses to Ethics Consultation." Bioethics 31, no. 4 (April 17, 2017): 267–76. http://dx.doi.org/10.1111/bioe.12345.
Full text
16
Kogut, Ashlynn, and Pauline Melgoza. "An Evaluation of Methods to Assess Team Research Consultations." Evidence Based Library and Information Practice 15, no. 3 (September 15, 2020): 36–58. http://dx.doi.org/10.18438/eblip29698.
Full textAbstract:
Abstract Objective – Due to the individualized nature of consultations and institutional constraints, research consultations can be challenging to assess. At Texas A&M University Libraries, subject librarians use research consultations to teach information literacy to upper-division engineering student teams working on a technical paper project. This paper describes an action research project designed to evaluate which assessment method for consultations with student teams would provide the most actionable data about the instruction and the consultation logistics as well as optimize librarian time. Methods – For three semesters, we simultaneously used up to four consultation assessment methods: one-minute papers, team process interviews, retrospective interviews, and questionnaires. We followed the action research cycle to plan the assessments, implement the assessments, reflect on the data collected and our experiences implementing the assessments, and revise the assessments for the next semester. Each assessment method was distributed to students enrolled in an engineering course at a different point in the technical paper project. The one-minute paper was given immediately after the consultation. The team process interviews occurred after project deliverables. The questionnaire was distributed in-person on the last day of class. Focus groups were planned for after the assignment was completed, but low participation meant that instead of focus groups we conducted retrospective interviews. We used three criteria to compare the assessments: information provided related to the effectiveness of the instruction, information provided about the logistics of the consultation, and suitability as an assessment method in our context. After comparing the results of the assessment methods and reflecting on our experiences implementing the assessments, we modified the consultation and the assessment methods for the next semester. Results – Each assessment method had strengths and weaknesses. The one-minute papers provided the best responses about the effectiveness of the instruction when questions were framed positively, but required the most staff buy-in to distribute. The team process interviews were time intensive, but provided an essential understanding of how students think about and prepare for each progress report. Recruiting for and scheduling the focus groups required more time and effort than the data collected about the instruction and logistics warranted. The questionnaire provided student perspectives about their learning after the assignment had been completed, collected feedback about the logistics of the consultations, was easy to modify each semester, and required minimal librarian time. Conclusion – Utilizing multiple assessment methods at the same time allowed us to determine what would work best in our context. The questionnaire, which allowed us to collect data on the instruction and consultation logistics, was the most suitable assessment method for us. The description of our assessment methods and our findings can assist other libraries with planning and implementing consultation assessment.
17
Hoberg, George, and Jeffrey Phillips. "Playing Defence: Early Responses to Conflict Expansion in the Oil Sands Policy Subsystem." Canadian Journal of Political Science 44, no. 3 (September 2011): 507–27. http://dx.doi.org/10.1017/s0008423911000473.
Full textAbstract:
Abstract. This article examines how powerful policy actors defend themselves against opponents' strategies of conflict expansion through a case study on the oil sands of Alberta. In response to an escalation of criticism of its performance on environmental regulation and related issues, the government of Alberta has pursued a strategy of engaging in several multi-stakeholder consultations. We argue that in examining subsystem change, it is essential to go beyond an examination of formal institutional mechanisms to examine policy impacts. Thus far, despite a significant pluralisation of consultative mechanisms on the oil sands, there is little or no evidence of a shift in power away from pro-oil sands interests. This strategy of selective opening is designed to bolster the legitimacy of the policy process while maintaining control over decision rules and venues.Résumé. Cet article étudie le rapport de force et la stratégie de défense des acteurs politiques lorsqu'un conflit dégénère, comme cela s'est produit dans le dossier des sables bitumineux de l'Alberta. Devant une recrudescence des critiques à l'égard de sa performance au chapitre de la réglementation environnementale, le gouvernement de l'Alberta a adopté une stratégie qui consiste à effectuer des consultations avec plusieurs intervenants. Nous soutenons qu'en examinant les changements du sous-système, il est vital d'aller au delà de la simple étude des mécanismes institutionnels pour évaluer l'impact des politiques. En dépit de la pluralité des mécanismes de consultation mis en place, rien ne semble indiquer qu'une partie quelconque du pouvoir ait échappé aux acteurs de l'exploitation des sables bitumineux. Cette stratégie d'ouverture sélective est conçue pour renforcer la légitimité du processus politique tout en gardant le contrôle sur les prises de décision et les centres décisionnels.
18
Søvsø, Morten Breinholt, Hejdi Gamst-Jensen, Morten Bondo Christensen, Linda Huibers, Freddy Lippert, and Erika Frischknecht Christensen. "Triage response by two different out-of-hours healthcare services: an observational cohort study." Dansk Tidsskrift for Akutmedicin 2, no. 3 (April 30, 2019): 32. http://dx.doi.org/10.7146/akut.v2i3.112939.
Full textAbstract:
Background: The entry points to Danish acute care are the out-of-hours health care services (OOH) and emergency medical services (EMS). Where EMS is organized in a similar manner throughout Denmark, the OOH is not. Four regions (including the North Denmark Region) have a general practitioner operated service (OOH-GP), whereas the Capital Region of Copenhagen, (Copenhagen) Denmark has the Medical Helpline 1813, (OOH-1813) which is staffed by nurses and physicians. Nationally, access to out-of-hours healthcare and emergency departments requires referral by one of the healthcare services. The OOH services in the North Denmark Region and Copenhagen handle similar patients and health problems; however, no published research has compared the type of actions performed in response to patient calls. We investigated and compared the type of triage response given by OOH-GP and OOH-1813 to patient contacts in the study period and the proportion of subsequent hospitalization.
Methods: Observational cohort study of patients contacting OOH-GP and OOH-1813 from January 24th to February 9th, 2017. Patients with valid personal identification numbers were included. Primary outcomes were action performed by the call-handler i.e. telephone consultation, face-to-face consultation, home visit and hospitalization within 24 hours. Hospitalization was defined as a hospital stay of ≥24 hours.
Results: We included 32,489 contacts (OOH-GP: 21,149 and OOH-1813: 11,340 (representative sample)). Calls to the OOH-GP were handled as follows: 67.2% (n=14,214) telephone consultation only, 32.8% (n=6,935) face-to-face consultations including 1,089 home visits (5.1%). In comparison, at OOH-1813, 51% (n=5,763) were handled by telephone consultation only, 49% (n=5,575) were triaged to face-to-face consultation including 38 home visits (0.44%). The differences in triage were statistically significant (p<0.05). Subsequent admissions occurred after 524 (4.6%) OOH-1813 contacts and 798 (3.8%) OOH-GP contacts (OR = 1.22 (1.01;1.27)).
Conclusions: This comparison of OOH-1813 and OOH-GP shows significant differences in the triage responses, among these, notably more face-to-face consultations at OOH-1813. Subsequent hospitalizations were comparable with a small, but statistically significant, overrepresentation among the OOH-1813 cohort. These results could be due to the differences in organizational structure of the OOH or demographics in the two regions (capital vs city-rural), however further research is needed to determine this.
19
Spencer-Lane, Tim. "Safeguarding the public by regulating health and social care professionals: lessons from Mid-Staffordshire and the Law Commission review." Journal of Adult Protection 16, no. 1 (February 4, 2014): 52–59. http://dx.doi.org/10.1108/jap-06-2013-0024.
Full textAbstract:
Purpose – The purpose of this paper is to consider the final report of the Mid Staffordshire NHS Foundation Trust Public Inquiry and the Law Commissions’ review of health and social care professional regulation – and how these will impact on the professional regulation bodies. Design/methodology/approach – Summary and discussion of the relevant recommendations made by the Mid Staffordshire NHS Foundation Trust Public Inquiry and the initial Government response, and consultation responses to the Law Commissions’ provisional proposals for law reform of health and social care professional regulation. Findings – Future legislation is likely to be based on the recommendations of the Mid Staffordshire NHS Foundation Trust Public Inquiry and the Law Commissions. Originality/value – Overview of the Mid Staffordshire NHS Foundation Trust Public Inquiry and the initial Government response, and consultation responses to the Law Commissions.
20
VandeCreek, Larry, and Michael R. Sexton. "The Association for Clinical Pastoral Education Consultation Experience: Feedback from Basic and Advanced Students." Journal of Pastoral Care 48, no. 1 (March 1994): 55–63. http://dx.doi.org/10.1177/002234099404800107.
Full textAbstract:
Reports the results from a survey which invited responses from persons who sought consultation regarding completion of Basic and/or Advanced Clinical Pastoral Education status. Describes both quantitative and qualitative data and, based on these data, suggest steps which might be taken by candidates, their supervisors, and consultation committees to improve the process of consultation.
21
Geist, Shin-Mey Rose Y., and James R. Geist. "Improvement in Medical Consultation Responses with a Structured Request Form." Journal of Dental Education 72, no. 5 (May 2008): 553–61. http://dx.doi.org/10.1002/j.0022-0337.2008.72.5.tb04519.x.
Full text
22
Gillès de Pélichy, Estelle, Karsten Ebbing, Alcina Matos Queiros , Cécile Hanon, Armin von Gunten, Zaia Sellah, and Henk Verloo. "Demographics, Clinical Characteristics, and Therapeutic Approaches among Older Adults Referred to Mobile Psychiatric Crisis Intervention Teams: A Retrospective Study." Dementia and Geriatric Cognitive Disorders Extra 8, no. 3 (October 25, 2018): 402–13. http://dx.doi.org/10.1159/000493525.
Full textAbstract:
Background / Aims: The advent of mobile old age psychiatry intervention teams supports policies maintaining older adults in their habitual living environments, even those who are very old and suffering from acute cognitive and psychiatric impairments. Analyzing sociodemographic data, clinical and health characteristics, reasons for crisis-oriented psychiatric consultations, and other therapeutic suggestions for supporting home- or nursing home-dwelling older adult patients suffering from an onset of a psychiatric crisis. Methods: Reviews of the medical records and discharge letters of home- or nursing home-dwelling older adults who had undergone a consultation with the Lausanne region’s Mobile Old Age Psychiatry Teams (MOAPTs), between May 2016 and December 2017. Results: Of 570 older adult patients referred for consultation with MOAPTs, 333 had medical records and discharge letters eligible for retrospective analysis (59%). The majority of these older adult patients were women aged over 80 years suffering from dementia, mood disorders with and without a risk of suicide, and delirium. Challenging behaviors related to different stages of cognitive impairment were the most important clinical reason for crisis consultations. Nonpharmacological and pharmacological treatments were delivered concurrently in 68% of crisis consultations. Conclusion: Appropriate responses by dual nurse-psychiatrist teams using crisis-oriented nonpharmacological and pharmacological interventions decreased hospitalization.
23
O'Riordan, Dermot, and Jo Cripps. "Delivering high-quality surgical services for the future." Bulletin of the Royal College of Surgeons of England 88, no. 8 (September 1, 2006): 260–61. http://dx.doi.org/10.1308/147363506x144024.
Full textAbstract:
In March 2006 the reconfiguration working party published its initial report Delivering High-quality Surgical Services for the Future. This consultation document looked at the key reform dilemmas in the 'new NHS' and set out some potential future areas of work for the College. It was disseminated widely to surgeons, service planners, Trust, strategic health authority and Primary Care Trust chief executives and patient groups. The consultation closed on 30 June 2006 and the responses are being considered by the working party. This article examines the key features of the consultation responses and looks to the future, at how the College will take the reform agenda forward.
24
Burnham, Jason P., Stephanie Fritz, and Graham Colditz. "4054 Telemedicine Infectious Diseases Consultation in Rural Hospitals: Feasibility, Acceptability, Appropriateness, and Implementation." Journal of Clinical and Translational Science 4, s1 (June 2020): 146. http://dx.doi.org/10.1017/cts.2020.430.
Full textAbstract:
OBJECTIVES/GOALS: The objective of this study is to examine implementation science and clinical outcomes of telemedicine ID consultation at a rural Missouri hospital. METHODS/STUDY POPULATION: Pilot study, hybrid type 2, studying clinical outcomes (mortality, readmission, hospital transfer) and implementation outcomes assessed by survey and chart review (feasibility, acceptability, appropriateness, fidelity to guideline-based care). Telemedicine ID consultations are carried out for patients at Missouri Baptist Sullivan Hospital (MBSH) with positive blood cultures and charts reviewed for 30 days after hospital discharge. Patients, physicians, and staff complete surveys for implementation outcomes. The practical, robust implementation and sustainability model (PRISM) was chosen as the framework for this study and its future scale-up. RESULTS/ANTICIPATED RESULTS: There were 46 patients with positive blood cultures at MBSH, 20 of which were transferred or left from the ER before consultation could be offered. Eighteen patients had telemedicine ID consultation. The remaining 8 patients had contaminants in their blood cultures and therefore no consultation was offered. Of eligible patients not transferred, recruitment rate was 100% (18/18). Average total time per consult was 52.8 minutes on day 1, 8.5 minutes on day 2. 30-day mortality was 0%, 30-day readmission rate 5.5% (n = 1), hospital transfer rate 5.5% (n = 1). 13 patients and 9 providers completed the feasibility, acceptability, and appropriateness survey with zero negative responses on any measure. DISCUSSION/SIGNIFICANCE OF IMPACT: Telemedicine ID consultation at a single rural hospital has thus far been received as feasible, acceptable, and appropriate. Scale-up of this model of care remains to be studied.
25
Shapiro, Robin, Arne Hofmann, and Earl Grey. "Case Consultation: Unremitting Depression." Journal of EMDR Practice and Research 7, no. 1 (2013): 39–44. http://dx.doi.org/10.1891/1933-3196.7.1.39.
Full textAbstract:
Case Consultation is a new regular feature in the Journal of EMDR Practice and Research. In this article, an eye movement desensitization and reprocessing (EMDR) clinician briefly describes a challenging case in which a man, “George,” was referred for EMDR for treatment of a depression that began more than 2 years previously. After all his reported traumatic memories were completely processed with EMDR, George remains severely depressed and the therapist asks how to proceed effectively with treatment. Responses are written by three experts. The first expert, Robin Shapiro, describes a comprehensive list of possible etiologies, including attachment, early trauma, genetic, and other biological causes and their appropriate EMDR, ego state, or medical treatments. The second expert, Arne Hofmann, reviews the treatment that was provided and makes suggestions for alternate treatment targets, suggesting that the therapist could address the client’s belief that “nothing will change” and try the EMDR inverted protocol. The third expert, Earl Grey, recommends that the clinician focus on addressing small “t” traumas, even if the client indicates that he or she has little to no disturbance and explains how to develop and implement a “restorative life span target sequence.”
26
Kolstoe, John. "Using the Baha'i Method of Consultation." Journal of Bahá’í Studies 7, no. 4 (December 1, 1997): 1–15. http://dx.doi.org/10.31581/jbs-7.4.269(1997).
Full textAbstract:
Two studies were conducted to measure the improvement in accessing intelligent responses through the use of consultation. In the first study, eight subjects were given three sets of tasks to be completed as individuals. The hypotheses concerned use of the Wechsler Adult Intelligence Scale (WAIS). Three sets of scores were recorded: individual--scores earned by each one working independently; composite--the combined best answers from the individual work; and group scores--those earned by the decision reached through consultation. Comparisons were made between the composite and the group scores. The group did not perform any better in recall of knowledge of a general nature beyond the composite or combined results of its individual members. Improvement was seen in the areas of identifying relationships and practical judgment. The greatest gain was found in the WAIS subtest of comprehension. The group score of these subjects was two standard deviations above the composite score, which represented a change from the 71.5th percentile to the 99.4th percentile based on the normative population. A second study was conducted to measure the difference between a group that consulted on a task, as compared to individuals with similar background, training, and motivation who performed the same task as individuals. There was a clear advantage shown by consultation as compared to individual results. These results indicate that people consulting together can access intelligent responses superior to that atteined through individual effort. The studies suggest several areas of inquiry for further investigation.
27
Eccles, Abi, Mike Hopper, and Helen Atherton. "Patient feedback on a new method of consulting with the GP; an analysis of responses by users of online triage software." British Journal of General Practice 68, suppl 1 (June 2018): bjgp18X696773. http://dx.doi.org/10.3399/bjgp18x696773.
Full textAbstract:
BackgroundOnline triage software is a new way to triage patients online that allows patients to describe their problem via an online form. A GP then contacts the patient to arrange either a face-to-face or telephone consultation.AimThis study aimed to explore use of online consultation software and gain insight into patients’ experiences of using online consultations, identifying potential barriers and facilitators to use.MethodThis is a mixed methods retrospective study analysing data about patient users and their associated feedback. Data from a sample of 5591 patients were quantitatively analysed to describe characteristics of users. 576 out of the 5591 users left free-text feedback comments on their experience of use. These were thematically analysed.ResultsThe highest levels of use were observed in 25–35-year olds and lowest from those aged >65. Key themes identified included convenience, consultation quality, appropriateness, resource-use and functionality. Within each, a range of subthemes were present representing both positive and negative perceptions, suggesting that experiences of using online triage varied and were often context-dependentConclusionThere are various advantages to online triage software, but these are context-dependent. Therefore, such applications should be offered as an additional way to contact the GP surgery, rather than a replacement for more established methods, to ensure appropriate and equal access for patients.
28
Imai, N., N. Yagi, T. Konishi, M. Serizawa, and M. Kobari. "Websites offer helpful information concerning consultation with headache specialists." Cephalalgia 30, no. 4 (July 1, 2009): 496–99. http://dx.doi.org/10.1111/j.1468-2982.2009.01915.x.
Full textAbstract:
Patients with severe primary headache may benefit from consultation with headache specialists, but doctor attendance rates in Japan are very low. More headache patients might consult headache specialists if these specialists were more widely recognized by the public. To determine what information prompted patients to seek consultation with a headache specialist, we questioned 256 primary headache patients about the source of the helpful information concerning consultation with headache specialists. From 191 patients, a total of 235 responses to the questionnaire were obtained. The most common response was ‘websites’ (33.2%), followed by ‘professionals’ (23.8%), ‘acquaintances’ (20.9%), ‘print media’ (6.8%) and ‘TV/radio’ (3.4%). Patients who indicated websites showed the most severe pain and highest impact of headache, and accounted for 52.4% of those with cluster headaches. Development of websites concerning headache specialists would seem likely to increase doctor attendance rates for patients with primary headache.
29
Okazaki, Shigemi, Yumi Iwamitsu, Kuranami Masaru, Keiko Todoroki, Shimako Suzuki, Kenji Yamamoto, Masashi Hagino, Masahiko Watanabe, and Hitoshi Miyaoka. "The psychological responses of outpatient breast cancer patients before and during first medical consultation." Palliative and Supportive Care 7, no. 3 (September 2009): 307–14. http://dx.doi.org/10.1017/s147895150999023x.
Full textAbstract:
AbstractObjective:The purpose of this study was to qualitatively examine the content of the psychological responses in interviews with breast cancer outpatients receiving initial medical consultation.Method:The participants were 180 people who visited the breast cancer outpatient clinic at Kitasato University Hospital between November 2004 and August 2005. The remaining 176 participants (39 breast cancer patients and 137 benign tumor patients; average age ± SD: 50.7 ± 12.4 years) were analyzed. Two clinical psychologists carried out the interview, asking the participants to speak freely about their anxieties, worries, thoughts, and feelings up until the medical examination. This study used a content analysis of interviews to chronologically examine psychological response of cancer patients seeking medical consultation at three points in time.Results:Patients at the time of their first outpatient breast cancer consultation experience negative feelings before the examination, directly influenced by the suspicion of cancer. These include anxiety and worries, fear, evasion, depression, and impatience. These tendencies do not change at the time of consultation. However, in addition to negative feelings, some people also possess positive feelings, either simultaneously or at a different point in time. Further, many patients tend to talk at length about psychological responses before seeking treatment, understanding the process they went through to come to seek treatment as an important event.Significance of results:It is important for medical workers to bear in mind the psychological conflicts that patients may undergo before seeking treatment and ensure that sufficient communication takes place.
30
Pai, Ashok, Dinesh Kotak, Nancy Facher, Kyle Reader, Kevin Kong, Natalya Greyz, Jahan Tavakoli, et al. "Development of a Virtual Benign Hematology Consultation Service: Results of a Pilot Project Involving 5 Medical Centers." Blood 132, Supplement 1 (November 29, 2018): 824. http://dx.doi.org/10.1182/blood-2018-99-110009.
Full textAbstract:
Abstract Background: Benign hematology consultations constitute a sizable proportion of community hematology/oncology practices. There is a need for physicians with adequate training, experience, interest and expertise in evaluating and treating patients with these disorders1,2. Some hematologic issues are complex and require in-person histories and examinations, while others can be handled with advice electronically after a thorough chart review3. To improve the quality of the care provided to these patients, a virtual benign hematology consultative service was created. This program was developed in the setting of a multi-specialty group with a commonly accessible EMR, servicing 15 medical service area centers, each with their own hematology/oncology department. A pilot project was designed to evaluate the feasibility of performing benign hematology consults virtually with the goal of improving quality of care while simultaneously enhancing the expertise of the physicians performing the consultations. Methods: The setting for this program is a multi-specialty group with a capitated reimbursement model. A pilot project was begun in October 2017 between 2 participating medical centers and was expanded to include a total of 5 medical centers by April 2018. All non-urgent benign hematology consultation requests were submitted electronically through an 'e-consult' portal. Evidence based work ups for common hematologic conditions were developed with consensus amongst all 15 hematology departments and provided on the e-consultation landing pages. All urgent questions and in-patient consults were called in directly to an on-call physician. Results: Data from October 2017 through April 2018 are reported. During this time, there were 2013 consults submitted electronically for review. Of this, 1107 came under the non-specific 'Ask the Specialist' code, and 906 under a specific diagnosis code. Regarding the consults with a designated diagnosis code, anemia 239 (26.3%), abnormal SPEP 208 (22.9%), anticoagulation 142 (15.6%), thrombocytopenia 103 (11.3%), leukocytosis 73 (8.1%), thrombocytosis 56 (6.2%), erythrocytosis 45 (5.0%), leukopenia 40 (4.4%) were the most common inquires. The requests that came under the 'Ask the specialist' code included questions regarding iron deficiency, easy bruising, macrocytosis without anemia, elevated ferritin levels and an elevated PT/PTT to name a few . Of the 1107 'Ask the specialist' consults, 941 (85.0%) were handled with advice given electronically while 116 (15%) were triaged to an in-person appointment. When evaluating the specific diagnosis codes, 575 (63.4%) were handled with advice given electronically. The most commonly triaged diagnosis for in-person appointments were thrombocytosis (60.7%), leukopenia (50.0%) and thrombocytopenia (47.6%). 90.3% of the consultation requests were addressed within 24 hours. When evaluating the number of consults on each day of the week, there were an average of 32.7, 25.8, 19.6, 24.4 and 18.2 consults triaged Monday through Friday respectively. The time necessary to complete an electronic consult was calculated based on data from 7 hematologists with a sample size of 197 consults. It took an average of 14.47 minutes to complete each consultation when performed electronically (95% CI, 14.02 mins - 14.91 mins). This is similar to the time reported by Cecchini et al. in their experience with this program at the VA health system3. All referring physicians were surveyed regarding their perceptions of the program, scaling their responses from 1 to 5. When asked if the work-up algorithms were helpful, if the recommendations received were clear and whether it was easy to access the specialist, the weighted average responses were 4.60, 4.50 and 4.0 respectively. Conclusions: This was a pilot program to assess the feasibility of a virtual hematology consultative service. The initial success of the program shows that it is possible to provide high value consultations to referring providers in an expeditious manner that enhances quality of care by having experts focused in the area perform the evaluation. Patients are also spared a visit to the hematology/oncology clinic to discuss a benign condition, and therefore has the added benefit of reduced anxiety4. Future studies will involve measuring outcomes of patients who were managed virtually, and the effect of the recommendations on the utilization of laboratory tests. Disclosures No relevant conflicts of interest to declare.
31
Harno, K., P. Nykänen, and K. Häyrinen. "Use of Headings and Classifications by Physicians in Medical Narratives of EHRs." Applied Clinical Informatics 02, no. 02 (2011): 143–57. http://dx.doi.org/10.4338/aci-2010-12-ra-0073.
Full textAbstract:
Summary Objective: The purpose of this study was to describe and evaluate patient care documentation by hospital physicians in EHRs and especially the use of national headings and classifications in these documentations Material and Methods: The initial material consisted of a random sample of 3,481 medical narratives documented in EHRs during the period 2004-2005 in one department of a Finnish central hospital. The final material comprised a subset of 1,974 medical records with a focus on consultation requests and consultation responses by two specialist groups from 871 patients. This electronic documentation was analyzed using deductive content analyses and descriptive statistics. Results: The physicians documented patient care in EHRs principally as narrative text. The medical narratives recorded by specialists were structured with headings in less than half of the patient cases. Consultation responses in general were more often structured with headings than consultation requests. The use of classifications was otherwise insignificant, but diagnoses were documented as ICD 10 codes in over 50% of consultation responses by both medical specialties. Conclusion: There is an obvious need to improve the structuring of narrative text with national headings and classifications. According to the findings of this study, reason for care, patient history, health status, follow-up care plan and diagnosis are meaningful headings in physicians’ documentation. The existing list of headings needs to be analyzed within a consistent unified terminology system as a basis for further development. Adhering to headings and classifications in EHR documentation enables patient data to be shared and aggregated. The secondary use of data is expected to improve care management and quality of care.
32
Asken, Michael J. "The Challenge of the Physically Challenged: Delivering Sport Psychology Services to Physically Disabled Athletes." Sport Psychologist 5, no. 4 (December 1991): 370–81. http://dx.doi.org/10.1123/tsp.5.4.370.
Full textAbstract:
This paper discusses the delivery of sport psychology services to physically challenged (disabled) athletes. It begins with a description of the current status of athletic competition for physically disabled individuals. Commonalities in the sports experience of able-bodied and physically disabled athletes are addressed. Unique issues that must be considered for effective sport psychology consultations with disabled athletes are discussed. These include the background of physical and psychological trauma, altered physiological responses and medical problems, complexities in motivation to compete, unique performance problems, and the structure and organization of disabled sports. The article concludes with the effects of the social environment of disabled sports on the consultation process.
33
Bishop, Kenneth D., and Angela Marie Taber. "Perspectives on palliative care in a multisite oncology practice." Journal of Clinical Oncology 32, no. 31_suppl (November 1, 2014): 52. http://dx.doi.org/10.1200/jco.2014.32.31_suppl.52.
Full textAbstract:
52 Background: The Institute of Medicine reported that many cancer patients do not receive palliative care to manage symptoms. It is possible that practitioners do not identify palliative care as an important component of high-quality cancer care, or do not know how to most efficiently utilize available palliative care consultative services. Methods: An anonymous electronic survey was sent to physicians, nurses, nurse practitioners, physician assistants, and social workers (n=99) in our multi-site, single-institution Cancer Center. Results: Sixty-five responses were received (66% response rate). Eighty-three percent of respondents reported working primarily in the outpatient setting. Fifty-nine percent reported their patients ‘rarely use the ER for pain management’ while 16% reported their patients ‘frequently require ER visits for pain management’. Ninety-two percent considered palliative care ‘an integral part of a multidisciplinary team’ while 6% reported palliative care consultation to be ‘cumbersome to consult and coordinate with’. The most common reason for consultation was end-of-life discussions (38%) followed by chronic pain management (33%). Seventy-seven percent reported consulting between 1 and 5 times per month, 14% between 6-10 times per month, and 5% greater than 11 times per month. Thirteen percent reported that they were able to manage patient symptoms adequately themselves. The average rating for convenience of consulting palliative care was 3.8/5. Fifty-eight percent reported the most effective means of communication with palliative care consultants was through the medical record, whereas 42% reported that most effective communication took place in person. Sixty percent reported a preference for palliative care practitioners from within the division of hematology/oncology. Conclusions: Our survey suggests that the majority of oncology practitioners value palliative care consultation and are willing to incorporate palliative care services into patient management. It is possible that practitioners overestimate their utilization of palliative care services and that optimizing the convenience of consultation and communication would result in better integration of palliative care for cancer patients.
34
Alschuler, Kevin N., Gary A. Stobbe, Deborah P. Hertz, Kurt L. Johnson, Gloria von Geldern, Annette Wundes, Piper Reynolds, Kent Unruh, and John D. Scott. "Impact of Multiple Sclerosis Project ECHO (Extension for Community Healthcare Outcomes) on Provider Confidence and Clinical Practice." International Journal of MS Care 21, no. 4 (July 1, 2019): 143–50. http://dx.doi.org/10.7224/1537-2073.2018-014.
Full textAbstract:
Abstract Background: Project ECHO (Extension for Community Healthcare Outcomes) represents a novel approach to addressing disparities in multiple sclerosis (MS) care. A primary mechanism of the program is the use of case consultations to rapidly transfer knowledge from content experts to community providers who care for individuals with MS. Methods: MS Project ECHO was pilot tested as a weekly 60-minute videoconference delivered to 24 clinicians across 13 practice sites over 41 weeks. Participants completed a variety of measures related to their experience in the program and answered qualitative questions via exit interview. We report on the responses to exit interview questions related to the case consultation component of MS Project ECHO. Results: Participant responses regarding case consultations generated four themes: 1) improved confidence among participants in the existing treatment decision, 2) direct change in the care of the patient provided by the participant, 3) changed practice habits for all of the participant's patients with MS, and 4) increased perception that patients had confidence in the participant as an MS care provider. Conclusions: Participant responses support MS Project ECHO as a program that may directly and indirectly affect the way providers deliver MS care in underserved areas. Further research is needed to examine the resulting effect on patient outcomes.
35
Robinson, Natalie Jane, Zoe Belshaw, Marnie Louise Brennan, and Rachel S. Dean. "Topics discussed, examinations performed and strategies implemented during canine and feline booster vaccination consultations." Veterinary Record 184, no. 8 (February 18, 2019): 252. http://dx.doi.org/10.1136/vr.104835.
Full textAbstract:
Vaccination consultations account for a large proportion of the small animal veterinary caseload. The aim of this study was to determine the content of canine and feline booster vaccination consultations and gather opinions on strategies used to optimise these consultations. An online survey of UK veterinarians was conducted. Respondents were asked about the clinical examination performed and the topics discussed during vaccination consultations, as well as any strategies used to optimise these consultations. Finally, respondents were asked about the practicality and effectiveness of various potential strategies. A total of 662 responses were received. Most respondents always auscultated the chest during vaccination consultations (n=603/621, 97.1% canine consultations; n=587/610, 96.2% feline consultations). Microchipping was discussed more frequently during canine versus feline consultations (P<0.001). Over half of respondents (n=323/597; 54.1%) had tried strategies to optimise consultations, with supplementary reading material tried most frequently (n=203/597; 34.0%). There were a range of opinions around practicality and effectiveness of these strategies. The results from this novel study suggest that vaccination consultations vary in terms of the clinical examination performed, topics discussed and strategies used to optimise the consultation. This study has implications for practice by identifying potential ways to maximise the benefits of vaccination consultations.
36
Flavell, David J., Sopsamorn U. Flavell, and Richard Sullivan. "European Clinical Trials Directive: responses made to MHRA consultation letter MLX 287." Lancet 362, no. 9393 (October 2003): 1415. http://dx.doi.org/10.1016/s0140-6736(03)14646-6.
Full text
37
Kim, Hye-Ri, Ji-Hong Shon, Young-Ran Yoon, Eun-Ju Lim, Young-Hae Lim, Young-Dae Jin, Moon-Kyu Ahn, Jae-Gook Shin, and In-June Cha. "Analysis of Prescriber's responses on Clinical Pharmacokinetic Consultation of Therapeutic Drug Monitoring." Journal of Korean Society for Clinical Pharmacology and Therapeutics 9, no. 2 (2001): 163. http://dx.doi.org/10.12793/jkscpt.2001.9.2.163.
Full text
38
Forgash, Carol, Andrew Leeds, Claire A. I. Stramrood, and Amy Robbins. "Case Consultation: Traumatized Pregnant Woman." Journal of EMDR Practice and Research 7, no. 1 (2013): 45–49. http://dx.doi.org/10.1891/1933-3196.7.1.45.
Full textAbstract:
Case consultation is a new regular feature in the Journal of EMDR Practice and Research in which a therapist requests assistance regarding a challenging case and responses are written by three experts. In this article, Amy Robbins, a certified eye movement desensitization and reprocessing (EMDR) therapist from Atlanta, Georgia, briefly describes a challenging case in which a pregnant woman seeks treatment for trauma suffered in a tornado. The clinician asks if it is advisable to provide EMDR treatment and what concerns she should be aware of. The first expert, Carol Forgash, provides some general information about pregnancy and psychotherapy and outlines considerations, concerns, and contraindications for proceeding with EMDR. She recommends that if treatment is chosen, the therapist proceed with a recent trauma protocol to specifically target the traumatic memories of the recent tornado. The second expert, Andrew Leeds, comments on the absence of randomized controlled trials (RCTs) or other scientific reports exploring the safety of EMDR treatment of pregnant women. He states that pregnant women with symptoms of posttraumatic stress should understand that there is a high probability that EMDR will improve maternal quality of life and that the risks of adverse effects on stability of pregnancy are probably low, but that these remain unknown. The third expert, Claire Stramrood, explains that the few case studies that evaluated EMDR during pregnancy have found positive effects but pertained to women with posttraumatic stress disorder (PTSD) following childbirth. She asserts that once obstetricians have been consulted, women have been informed about possible risks and benefits, and, given their informed consent, they should be able to choose to commence EMDR therapy during pregnancy.
39
Zaidi, Danish, and Jennifer C. Kesselheim. "Assessment of orientation practices for ethics consultation at Harvard Medical School-affiliated hospitals." Journal of Medical Ethics 44, no. 2 (August 5, 2017): 91–96. http://dx.doi.org/10.1136/medethics-2016-103909.
Full textAbstract:
BackgroundFew studies have been conducted to assess the quality of orientation practices for ethics advisory committees that conduct ethics consultation. This survey study focused on several Harvard teaching hospitals, exploring orientation quality and committee members’ self-evaluation in the American Society of Bioethics and Humanities (ASBH) ethics consultation competencies.MethodsWe conducted a survey study that involved 116 members and 16 chairs of ethics advisory committees, respectively (52% and 62.5% response rates). Predictor variables included professional demographics, duration on committees and level of training. Outcome variables included familiarity with and preparedness in the ASBH competencies and satisfaction with orientations. We hypothesised that responses would be associated with both the aforementioned predictors and whether or not participants had encountered the ASBH competencies in training.ResultsA majority of respondents found their orientation curricula to be helpful (62%), although a significant portion of respondents did not receive any orientation (24%) or were unsatisfied with their orientation (14%). Familiarity with ASBH competencies was a statistically significant predictor of respondents’ self-evaluation in particular categories (54% had heard of the competencies). Standard educational materials were reported as offered during orientation, such as readings (50%) and case studies (41%); different medium resources were less evidenced such as videos on ethics consultation (19%).ConclusionsInstitutions should re-evaluate orientation practices for ethics committee members that perform ethics consultation. Integrating ASBH competencies and useful methods into a resourceful pedagogy will help improve both member satisfaction with orientation and preparation in consultation.
40
van der Velden, Alike W., Eva A. Bax, Emily Bongard, Rune Munck Aabenhus, Marilena Anastasaki, Sibyl Anthierens, Anca Balan, et al. "Primary care for patients with respiratory tract infection before and early on in the COVID-19 pandemic: an observational study in 16 European countries." BMJ Open 11, no. 7 (July 2021): e049257. http://dx.doi.org/10.1136/bmjopen-2021-049257.
Full textAbstract:
ObjectiveTo describe primary health care (consultation characteristics and management) for patients contacting their general practitioner (GP) with a respiratory tract infection (RTI) early on in the COVID-19 pandemic in contrasting European countries, with comparison to prepandemic findings.SettingPrimary care in 16 countries (79 practices), when no routine SARS-CoV-2 testing was generally available.Design and participantsBefore (n=4376) and early in the pandemic (n=3301), patients with RTI symptoms were registered in this prospective audit study.Outcome measuresConsultation characteristics (type of contact and use of PPE) and management characteristics (clinical assessments, diagnostic testing, prescribing, advice and referral) were registered. Differences in these characteristics between countries and between pandemic and prepandemic care are described.ResultsCare for patients with RTIs rapidly switched to telephone/video consultations (10% in Armenia, 91% in Denmark), and when consultations were face-to-face, GPs used PPE during 97% (95% CI 96% to 98%) of contacts. Laboratory testing for SARS-CoV-2 in primary care patients with RTIs was rapidly implemented in Denmark (59%) and Germany (31%), while overall testing for C reactive protein decreased. The proportion of patients prescribed antibiotics varied considerably between countries (3% in Belgium, 48% in UK) and was lower during the pandemic compared with the months before, except for Greece, Poland and UK. GPs provided frequent and varied COVID-related advice and more frequently scheduled a follow-up contact (50%, 95% CI 48% to 52%). GPs reported a slightly higher degree of confidence in the likely effectiveness of their management in face-to-face (73% (very) confident, 95% CI 71% to 76%) than in virtual consultations (69%, 95% CI 67% to 71%).ConclusionsDespite between-country variation in consultation characteristics, access to SARS-CoV-2 laboratory testing and medication prescribing, GPs reported a high degree of confidence in managing their patients with RTIs in the emerging pandemic. Insight in the highly variable pandemic responses, as measured in this multicountry audit, can aid in fine-tuning national action and in coordinating a pan-European response during future pandemic threats.
41
Wozniczka, Daniel, Hanna B. Demeke, Angela M. Thompson-Paul, Ugonna Ijeoma, Tonya R. Williams, Allan W. Taylor, Kathrine R. Tan, et al. "Real-Time CDC Consultation during the COVID-19 Pandemic—United States, March–July, 2020." International Journal of Environmental Research and Public Health 18, no. 14 (July 6, 2021): 7251. http://dx.doi.org/10.3390/ijerph18147251.
Full textAbstract:
Context: In response to the COVID-19 pandemic, the Centers for Disease Prevention and Control (CDC) clinicians provided real-time telephone consultation to healthcare providers, public health practitioners, and health department personnel. Objective: To describe the demographic and public health characteristics of inquiries, trends, and correlation of inquiries with national COVID-19 case reports. We summarize the results of real-time CDC clinician consultation service provided during 11 March to 31 July 2020 to understand the impact and utility of this service by CDC for the COVID-19 pandemic emergency response and for future outbreak responses. Design: Clinicians documented inquiries received including information about the call source, population for which guidance was sought, and a detailed description of the inquiry and resolution. Descriptive analyses were conducted, with a focus on characteristics of callers as well as public health and clinical content of inquiries. Setting: Real-time telephone consultations with CDC Clinicians in Atlanta, GA. Participants: Health care providers and public health professionals who called CDC with COVID-19 related inquiries from throughout the United States. Main Outcome Measures: Characteristics of inquiries including topic of inquiry, inquiry population, resolution, and demographic information. Results: A total of 3154 COVID-19 related telephone inquiries were answered in real-time. More than half (62.0%) of inquiries came from frontline healthcare providers and clinical sites, followed by 14.1% from state and local health departments. The majority of inquiries focused on issues involving healthcare workers (27.7%) and interpretation or application of CDC’s COVID-19 guidance (44%). Conclusion: The COVID-19 pandemic resulted in a substantial number of inquiries to CDC, with the large majority originating from the frontline clinical and public health workforce. Analysis of inquiries suggests that the ongoing focus on refining COVID-19 guidance documents is warranted, which facilitates bidirectional feedback between the public, medical professionals, and public health authorities.
42
Murry, Logan, Brandon Gerleman, Huiwen Deng, and Julie Urmie. "Cost-Savings and Patient Experience with a Pharmacy-Led Medicare Part D Consultation Service." INNOVATIONS in pharmacy 11, no. 2 (June 8, 2020): 10. http://dx.doi.org/10.24926/iip.v11i2.3191.
Full textAbstract:
Background: There are many Medicare Part D plans, making it difficult for patients to choose the optimal plan. The decision to remain on current Medicare plans is reinforced by patient inertia and uncertainty associated with plan-switching decisions. By helping patients identify more cost-effective plans, pharmacists and pharmacy personnel have the ability to inform plan-switching decisions resulting in lower out-of-pocket (OOP) costs.
Objectives: This study evaluates 1) patient experience with a pharmacy Medicare Part D consultation service and 2) potential out-of-pocket savings based on a patient’s best plan for 2019 compared to continuation of a patient’s 2018 Medicare Part D plan.
Methods: This study was a retrospective descriptive analysis and took place at a single, independently owned community pharmacy. Patients received free individual consultations with a pharmacist that included a medication review and information on all available Part D plans. Patients were selected to receive the service using pharmacy software to identify potential inefficiencies in current Part D plans. Data on satisfaction and perceived pharmacist role in providing Medicare Part D information were collected via an in-person survey administered at the pharmacy. Potential out-of-pocket cost savings were determined using cost information provided for patient specific medication regimens entered into Medicare.gov, the online platform for Medicare Part D plan information.
Results: Of the 318 patients identified, 79 used the consultation service. Out of 79 patients who used the service in fall of 2017, 44 completed the survey for a response rate of 56%.
Patients generally reported good experiences with the service. Open-ended responses revealed patients utilize a variety of helpers for plan information and decisions. A subset of 14 patients were identified as having clear plan-switching decisions and were included in the cost-savings analysis.
Conclusions: Patients using a free Medicare Part D plan consultation were satisfied with the service, suggesting that helpers were an important resource n their plan-selection process. Using the pharmacist-led Part D consultation may result in decreases in out-of-pocket cost savings due to identification of optimal Medicare Part D plans.
Article Type: Note
43
Kasten, Mary J., Abinash Virk, Jayawant Mandrekar, and Donna J. Springer. "1659. Electronic Consultations Combined with a Video Supported Powerpoint-based Pre-Travel Education Is Equivalent to In-Clinic Face-to-Face Pre-Travel Consultations in Appropriately Selected Travelers." Open Forum Infectious Diseases 6, Supplement_2 (October 2019): S607—S608. http://dx.doi.org/10.1093/ofid/ofz360.1523.
Full textAbstract:
Abstract Background Pre-travel consultation involves an in-clinic face-to-face consult (F2F) with a Travel Medicine provider. F2F involves education/counseling which is time-consuming for both patients and providers. Although electronic consultations (synchronous and asynchronous) are well established in many subspecialties, pretravel eConsults are not well known. We compared pretravel education via F2F to an innovative hybrid electronic consultation (HeC) combined with a Video Supported PowerPoint (VSP) for selected travelers. Methods We conducted a prospective trial comparing HeC-VSP to F2F to determine the quality of pretravel education. Study was approved by the Mayo Clinic IRB. Patients were enrolled from May 2014 through May 2015. Patients in both arms were given pretravel and post-travel surveys. Exclusions included age less than 18 years, first trip to Africa, immunocompromised host, non-English-speaking traveler, or travel for longer than 4 weeks. Results 194 patients were enrolled; 100 in HeC-VSP and 94 in F2F arm completed pretravel survey. Post-travel survey was completed in 54.2% (51/94) of the F2F, 67% (67/100) in the HeC-VSP group. The groups are similar in demographics and prior travel experience (Table 1). 36.2% of the F2F group felt that the consultation could have been effectively accomplished through a video-based education, while 33% felt that a F2F was needed; in contrast a majority (63.3%) in the HeC-VSP group would not have preferred a F2F consultation. HeC-VSP-based pretravel education was similar compared with that provided via the F2F consults. There were no statistically significant differences in the responses obtained in both groups to knowledge assessment questions (Table 2) except for one question. A higher proportion (76/100; 76%) in the HeC-VSP group compared with 55.4% (51/94) chose the correct response (P = 0.0018) regarding management of bloody diarrhea with fever. Self-reported change in behaviors to prevent travel-related illnesses was reported overall in 53% of the patients with no statistically significant differences between the groups. Conclusion Nonsynchronous eConsultation combined with VSP provides a viable solution to provide pretravel education for a select travel population. Disclosures All authors: No reported disclosures.
44
Norrie, Caroline, Jill Manthorpe, Stephen Martineau, and Martin Stevens. "The potential uses and abuses of a power of entry for social workers in England: a re-analysis of responses to a government consultation." Journal of Adult Protection 18, no. 5 (October 10, 2016): 256–65. http://dx.doi.org/10.1108/jap-04-2016-0009.
Full textAbstract:
Purpose Whether social workers should have a power of entry in cases where individuals seem to be hindering safeguarding enquiries for community-dwelling adults at risk is a topical question in England. The purpose of this paper is to present the findings of a re-examination of relevant sections of the 2012 Government Safeguarding Power of Entry Consultation. Design/methodology/approach Re-analysis of responses to question three of the 2012 Government’s Safeguarding Power of Entry Consultation was undertaken in late 2015-early 2016. The consultation submissions were located and searched for information on views of the prevalence of the situations where access to an adult at risk (with decision-making capacity) is being hindered by a third party and the nature of examples where a new power of entry might be considered appropriate by consultation respondents. Findings The majority of respondents to the consultation generally reported that situations when a new power of entry would be required were not encountered regularly; however a minority of respondents stated these situations occurred more frequently. Examples of situations where third parties appeared to be hindering access were given across the different categories of adults at risk and types of abuse and current practices were described. Respondents observed that the risks of excessive or inappropriate use of any new powers needed to be considered carefully. Originality/value This re-analysis sheds light on the prevalence and circumstances of the problems encountered about access to adults at risk. The legal framework of adult safeguarding continues to be of interest to policy makers, researchers and practitioners.
45
Moorthy, R., J. Grainger, A. Scott, JW Powles, and SG Lattis. "Surgical care practitioner – a confusing and misleading title." Bulletin of the Royal College of Surgeons of England 88, no. 3 (March 1, 2006): 98–100. http://dx.doi.org/10.1308/147363506x90754.
Full textAbstract:
In March 2005 the Department of Health released the Curriculum Framework for the Surgical Care Practitioner for consultation. The curriculum framework has been developed by a working party drawn from The Royal College of Surgeons of England (RCSE) Council and an NHS Changing Workforce Programme steering group, which represented a number of involved associations. As well as inviting responses on the curriculum itself, the consultation invited comments with respect to the title of 'surgical care practitioner'.
46
Maurizio, L. "Anthropology and spirit possession: A reconsideration of the Pythia's role at Delphi." Journal of Hellenic Studies 115 (November 1995): 69–86. http://dx.doi.org/10.2307/631644.
Full textAbstract:
During a consultation at Delphi, one of Apollo's servants imagined, heard, intuited, or feigned Apollo's presence and then uttered Apollo's divine response to the human client who made inquiry of the god. Such inspired mimicry appears incomprehensible to the non-believing distant observer to whom Apollo no longer speaks. Scholars hear nothing at Delphi and, steadfast in their faith in positivism, claim Apollo said nothing. In a similar fashion, scholars have pronounced that the Pythia, like Apollo, did not speak at Delphi, or that her attendant prophets reformulated her utterances and converted them into comprehensible prose or verse. Such a reconstruction of the divinatory consultation at Delphi, however, finds no support in the ancient evidence. Not one ancient source suggests that anyone other than the Pythia issued oracular responses.
47
Paik, Angie M., Mark S. Granick, and Sandra Scott. "Plastic surgery telehealth consultation expedites Emergency Department treatment." Journal of Telemedicine and Telecare 23, no. 2 (July 8, 2016): 321–27. http://dx.doi.org/10.1177/1357633x16639459.
Full textAbstract:
Plastic surgery is a field that is particularly amenable to a telehealth milieu, as visual exam and radiographs guide proper diagnosis and management. The goals of this study were to evaluate telehealth feedback executed through an iPad app for plastic surgery-related consultations. A Quality Assurance/Quality Improvement (QA/QI) study was conducted over a 1-month period during which patients with hand injuries, facial injuries, or acute wounds presenting to the Emergency Department (ED) of a level-one trauma centre and university hospital were monitored. The study utilized a commercial iPad application through which up to four images and a brief history could be sent to a remote Plastic Surgery Educator (PSE) for evaluation. The PSE would respond with best practice information, references and videos to assist ED point-of-care providers. During the 1-month period of this study, there were 42 ED consultations for plastic surgical conditions. There was a highly significant difference in overall mean response time between consultants and PSEs (48.3 minutes vs. 8.9 minutes respectively, p < 0.001). The agreement between PSEs and consultants regarding patient assessment and care was 85.7% for in-person consultations and 100% for phone consultations. In four cases of telephone consultations, the ED providers placed splints incorrectly on hand-injured patients. Our results show that telehealth consultations to a remote plastic surgeon based on digital images and a brief history were able to produce timely and accurate responses in an emergency care facility. This design may have significant impact in rural areas, underserved populations, or regions abroad.
48
Ruusuvuori, Johanna. "“Empathy” and “Sympathy” in Action: Attending to Patients' Troubles in Finnish Homeopathic and General Practice Consultations." Social Psychology Quarterly 68, no. 3 (September 2005): 204–22. http://dx.doi.org/10.1177/019027250506800302.
Full textAbstract:
This paper analyzes “empathy” and “sympathy” as situated practices, sequential processes that are coconstructed by the participants in the situation. The data consists of 228 sequences of patients' descriptions of their problematic experiences and professionals' responses to them in videorecorded general practice and homeopathic consultations. One deviant case, in which the practitioner shows compassion to the patient in an exceptional way, is subjected to detailed analysis. It is argued that both professionals and patients orient to a degree of professional neutrality in these situations, but also that affiliative practices can be adjusted to the otherwise problem-governed course of the consultation. These orientations seem to address questions similar to those of theoretical distinctions made between the terms empathy and sympathy.
49
Kımıloğlu, Elife, İrem Yanık, Özgecan Gündoğar, Sibel Bektaş, and Süleyman Salman. "Comparison and Analyses of Intraoperative Consultation and Paraffin Section Responses of Ovarian Lesions." Journal of Academic Research in Medicine 10, no. 3 (December 1, 2020): 237–40. http://dx.doi.org/10.4274/jarem.galenos.2020.3185.
Full text
50
Shah, Mindy, Timothy Quill, Sally Norton, Yvonne Sada, Marcia Buckley, and Charlotte Fridd. "“What Bothers You the Most?” Initial Responses From Patients Receiving Palliative Care Consultation." American Journal of Hospice and Palliative Medicine® 25, no. 2 (January 15, 2008): 88–92. http://dx.doi.org/10.1177/1049909107310138.
Full text