Journal of evaluation in clinical practice
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The aim of this study was to analyse the effects of the follow-up programme implemented by the Asan Medical Center Medical Emergency Team (MET). ⋯ The implementation of the MET follow-up programme did not change the rate of ICU readmission and cardiac arrest; however, its introduction was associated with the reduced ICU readmission of the high-risk patient populations discharged to the step-down unit.
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Multicenter Study
Burnout among anaesthetists in Chinese hospitals: a multicentre, cross-sectional survey in 6 provinces.
Anesthesiology has reached a new stage which anaesthesia safety is significantly affected by human factors. The number of Chinese anaesthetists has increased to nearly twice as many as that in 2005. Attributed to traditional concepts, many problems in anesthesiology persist in Chinese hospitals. This study aims to determine the current status of anaesthesia job burnout, including problems related to burnout, as well as the conditions of anaesthesia human resources in Chinese hospitals. ⋯ Anxiety and undesirable conditions experienced by professional groups in anaesthesiology need to be addressed. Educational level, an important factor in anaesthesia care, influences not only psychological health of practitioners but patient safety as well. Thus, personnel structure must be optimized to relieve tension in the practice of the profession and reduce burnout among anaesthetists in hospitals in China. Meanwhile, the management must increase its effort toward improving the mental health of practitioners and patient safety in anaesthesia care.
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The delivery of integrated care is a priority in many countries' efforts to improve health outcomes for people at risk of or with diabetes. This study aims to provide an overview of the different types of integrated care interventions for type 2 diabetes and to report their outcomes. ⋯ Future research would benefit from a more uniform understanding of integrated care as well as intermediate outcome measurements that allow for the establishment of a chain of evidence from specific intervention types to specific outcomes achieved. It is expected that such a comprehensive approach will reveal important insights as to which integrated care intervention types and settings are most conducive to successful implementation and would thereby be of relevance to policy makers and practitioners involved in the financing, management and delivery of integrated care.
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Randomized Controlled Trial
Implementing a patient-initiated review system for people with rheumatoid arthritis: a prospective, comparative service evaluation.
The management of rheumatoid arthritis (RA) usually entails regular hospital reviews with a specialist often when the patient is well rather than during a period of exacerbation. An alternative approach where patients initiate appointments when they need them can improve patient satisfaction and resource use whilst being safe. This service evaluation reports a system-wide implementation of a patient-initiated review appointment system called Direct Access (DA) for people with RA. The aim was to establish the impact on patient satisfaction of the new system versus usual care as well as evaluate the implementation processes. ⋯ This service evaluation found that DA could be implemented and it demonstrated patient benefit in a real-world setting. Further research establishing the broader cost-consequences across the whole patient pathway would add to our findings.
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In the UK fewer than 15% of familial hypercholesterolemia (FH) cases are diagnosed, representing a major gap in coronary heart disease prevention. We wished to support primary care doctors within the Medway Clinical Commissioning Group (CCG) to implement NICE guidance (CG71) and consider the possibility of FH in adults who have raised total cholesterol concentrations, thereby improving the detection of people with FH. ⋯ Our study shows that two simple interventions increased the detection of FH. This systematic yet simple electronic case-finding programme with nurse-led review allowed the identification of new index cases, more than doubling the recorded prevalence of detected disease to 1 in 357 (0.28%). This study shows that primary care has an important role in identifying patients with this condition.