Impact of web‐based clinical practice guidelines on paediatric fracture clinics

Camp, Mark; Barnes, James R.; Damany, Mohita; Donnan, Leo

doi:10.1111/ans.14260

Cited by 5 publications

(3 citation statements)

References 14 publications

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“…Literature in the field of clinical operations exists for many high-volume medical facilities, including the emergency department, medical clinics, and operating room. [28][29][30] MDA operates with a salaried staff as well as volunteers. 31 Most of these volunteers are at the level of an emergency medical technician or paramedic; however, some help with the clinical operations on an ad hoc basis.…”

Section: Discussionmentioning

confidence: 99%

Lessons Learned From an Analysis of the Emergency Medical Services’ COVID-19 Drive-Through Testing Facilities in Israel

Zmora

Alpert

Shacham

et al. 2021

Disaster med. public health prep.

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One strategy for the containment of a pandemic is mass testing. Magen David Adom (MDA), the Israeli National Emergency Medical Services (EMS) Organization undertook this mission by operating a nationwide series of drive-through testing complexes. The objective of this study is to learn lessons from an analysis of these centers. Data from 198 stationary and mobile drive-through complexes from March 20, 2020, through October 17, 2020, were analyzed for temporal and geographic factors, and cost. Also, an operational improvement program was implemented and analyzed. A total of 931,074 patients were sampled in the MDA drive-through system: 46.9% in stationary complexes, and 53.1% in mobile complexes. The optimized cost per patient of home testing was estimated at 74.5 USD compared to 6.55 USD in the drive-through centers. An operational improvement program lowered the total sampling time from 128 seconds per patient to 98 seconds and decreased the total cost per patient from 6.55 USD to 6.27 USD. The EMS led drive-through complexes were cost-effective and efficient in performing large numbers of viral tests, especially when compared to home testing. Established concepts in clinical operations should be implemented to increase the number of persons that can be tested and decrease cost.

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Section: Discussionmentioning

confidence: 99%

Lessons Learned From an Analysis of the Emergency Medical Services’ COVID-19 Drive-Through Testing Facilities in Israel

Zmora

Alpert

Shacham

et al. 2021

Disaster med. public health prep.

View full text Add to dashboard Cite

show abstract

“…It is important that the use and interpretation of these tests are accompanied by clinical guidance, allowing management of conditions previously considered too high risk to be treated in the community. With the increase in the incidence of chest pain in general practice (Biesemans et al, 2018), protocols are being developed and piloted in UCCs for the evaluation of acute coronary syndrome (Radecki et al, 2019), fracture management (Camp et al, 2018) and antibiotic prescribing (Verbakel et al, 2019). The setting up of UCCs could be guided by already existing standards (RNZCUC, 2015;Queensland Health, 2019;HealthPathways Community, 2020).…”

Section: Discussionmentioning

confidence: 99%

Urgent care in the community: an observational study

Adie

Graham

Bromfield³

et al. 2021

JHOM

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PurposeThis case study describes a community-based urgent care clinic in a general practitioner (GP) super clinic in South East Queensland.Design/methodology/approachThis retrospective chart audit describes patient demographic characteristics, types of presentations and management for Sundays in 2015.FindingsThe majority of patients (97%) did not require admission to hospital or office investigations (95%) and presented with one condition (94%). Of the presentations, 66.5% were represented by 30 conditions. Most patients received a prescription (57%), some were referred to the pathology laboratory (15%) and some were referred to radiology (12%). A majority (54%) of patients presented in the first three hours. Approximately half (51%) of patients presenting were aged under 25. More females (53%) presented than males. A majority (53%) lived in the same postcode as the clinic. The three most common office tests ordered were urinalysis, electrocardiogram (ECG) and urine pregnancy test. Some patients (19%) needed procedures, and only 3% were referred to hospital.Research limitations/implicationsThe study offers analysis of the client group that can be served by an urgent care clinic in a GP super clinic on a Sunday. The study provides an option for emergency department avoidance.Originality/valueDespite calls for more research into community-based urgent care clinics, little is known in Australia about what constitutes an urgent care clinic. The study proposes a classification system for walk-in presentations to an urgent care clinic, which is comparable to emergency department presentations.

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“…Most institutions across the United States do not formally address neonatal EOL care in a guideline format ( 1 ). However, implementation of clinically practical guidelines increases consistency in patient care as well as education and comfort of staff/trainees ( 4 , 38 , 68 , 69 ). Neonatal EOL guidelines should be individualized by institution and case to case as necessary.…”

Section: Institutional Neonatal Eol Care Guidelinesmentioning

confidence: 99%

End-of-Life Care for Neonates: Assessing and Addressing Pain and Distressing Symptoms

2020

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One of the most essential components of end-of-life (EOL) care for neonates is assessing and addressing distressing symptoms. There is limited evidence to guide neonatal EOL symptom management and therefore significant variety in treatment (1-4). EOL neonatal palliative care should include identifying and relieving distressing symptoms. Symptoms to manage at neonatal EOL may include pain using both non-pharmacologic and pharmacologic comfort measures, respiratory distress, secretions, agitation and neurologic symptoms, nutrition and gastrointestinal distress, and skin care. Also of equal importance is communication surrounding familial existential distress and psychosocial care (1, 5-7). Institutions should implement a guideline for neonatal EOL care as guidelines have been shown to decrease variability of interventions and increase use of pharmacologic symptom management (4). Providers should consult with palliative care teams if available for added multidisciplinary support for family and staff, which has been shown to enhance EOL care in neonates (8, 9).

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Impact of web‐based clinical practice guidelines on paediatric fracture clinics

Abstract: The implementation of web-based fracture pathways for upper extremity paediatric fractures was associated with a decrease in clinic resource utilization at a tertiary-care children's hospital.

Cited by 5 publications

References 14 publications

Lessons Learned From an Analysis of the Emergency Medical Services’ COVID-19 Drive-Through Testing Facilities in Israel

Lessons Learned From an Analysis of the Emergency Medical Services’ COVID-19 Drive-Through Testing Facilities in Israel

Urgent care in the community: an observational study

End-of-Life Care for Neonates: Assessing and Addressing Pain and Distressing Symptoms

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