Internal medicine journal
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Internal medicine journal · Jan 2004
Audit of consultant physicians' reply letters for referrals to clinics in a tertiary teaching hospital.
Doctors referring patients to consultant physicians seek reply letters which both educate and assist in ongoing patient management. Highly desirable attributes in specialist letters include clearly stated and justified: (i) diagnostic formulations, (ii) management regimens, (iii) use of clinical investigations, (iv) prognostic statements, (v) contingency plans and (vi) follow-up arrangements. ⋯ Opportunities exist for improving quality of consultant physicians' reply letters in terms of greater use of problem lists, contingency plans, prognostic statements and patient-centred assessments, as well as more frequent enunciation of consultants' reasoning behind requests for further tests and changes to current management. Use of structured letter templates may facilitate more consistent inclusion of key information to referring doctors.
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Internal medicine journal · Dec 2003
Audit of surgeon awareness of readmissions with venous thrombo-embolism.
An audit was undertaken to assess whether surgeons were informed of the readmission of their patients with postoperative deep venous thrombosis (DVT), or pulmonary embolus (PE). ⋯ The rate of DVT/PE complications following surgery is underestimated. This may lead to a reduced emphasis in DVT/PE prophylaxis in the mistaken belief that DVT/PE frequency is rarer than it is. Improved communication between teams is necessary to improve care.
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Internal medicine journal · Dec 2003
Letter Case ReportsOctreotide treatment of severe diabetic diarrhoea.
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Internal medicine journal · Dec 2003
Advance directives and emergency department patients: ownership rates and perceptions of use.
Advance directives (ADs) are rarely available in Australia to guide management but may become more important as our population ages. ⋯ AD knowledge and ownership rates were low. However, most patients perceive them favourably and many would consider owning one. Intervention strategies to improve AD awareness are indicated. This may empower patients to more effectively participate in their own advance care planning.
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Internal medicine journal · Dec 2003
Australasian haematologist referral patterns to palliative care: lack of consensus on when and why.
Patients with haematological malignancies are not referred to palliative care services as frequently as those with solid cancers (non-haematological malignancies). ⋯ In theory there is a willingness to refer to palliative care, however this has yet to be translated to day-to-day practice. This may be due to prognostication difficulties, logistical factors and medical concerns. Models of referral are suggested for further study.