Perception and Acceptability of Virtual Ward Round Reviews of Vascular Inpatients to Preserve Resources and Reduce Infection Risk in the COVID-19 Era

Glasgow, Simon; Saha, Prakash; Moore, Hayley; James, B. R.; Newsholme, William; Zayed, Hany

doi:10.1016/j.ejvs.2020.11.014

Cited by 5 publications

(3 citation statements)

References 5 publications

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“…These new models not only free up scarce and expensive hospital capacity, but they are also likely to reduce hospital-acquired infections, length of stay, and overall health care expenditure. [7][8][9][10] HaH is in line with trends for digitalizing health care and increasing patient and caregiver preferences for recovering at home. 11 However, a reliable cost analysis of these models is lacking.…”

Section: Introductionmentioning

confidence: 79%

“…While emerging from the COVID-19 pandemic, the continued implementation of these models now depends on the cost of running these services. These new models not only free up scarce and expensive hospital capacity, but they are also likely to reduce hospital-acquired infections, length of stay, and overall health care expenditure . HaH is in line with trends for digitalizing health care and increasing patient and caregiver preferences for recovering at home .…”

Section: Introductionmentioning

confidence: 99%

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Economic Evaluation of Novel Models of Care for Patients With Acute Medical Problems

Goh,

Xin,

Lim

et al. 2023

JAMA Netw Open

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ImportanceDuring COVID-19, Singapore simultaneously experienced a dengue outbreak, and acute hospitals were under pressure to lower bed occupancy rates. This led to new models of care to treat patients with acute, low-severity medical conditions either at home, in a hospital-at-home (HaH) model, or in a clinic-style setting sited at the emergency department in an ambulatory care team (ACT) model, but a reliable cost analysis for these models is lacking.ObjectiveTo compare personnel costs of HaH and ACT with inpatient care.Design, Setting, and ParticipantsIn this economic evaluation study, time-driven activity-based costing was used to compare the personnel cost of inpatient care with treating dengue via HaH and treating chest pain via ACT. Participants were patients with nonsevere dengue and chest pain unrelated to a coronary event admitted via the emergency department to the internal medicine service of a tertiary hospital in Singapore.ExposuresHaH for dengue and ACT for chest pain.Main Outcomes and MeasuresA process map was created for the patient journey for a typical patient with each condition. The amount of time personnel spent on delivering care was estimated and the cost per minute determined based on their wages in 2022. The total cost of care was calculated by multiplying the time spent by the per-minute cost of the personnel resource and summing all costs.ResultsCompared with inpatient care, HaH used 50% less nursing time (418 minutes, 95% uncertainty interval [UI], 370 to 465 minutes) but 80% more medical time (303 minutes, 95% UI, 270 to 338 minutes) per case of dengue. If implemented nationally, HaH would save an estimated 56 828 SGD per year (95% UI, −169 497 to 281 412 SGD [US $41 856; 95% UI, −$124 839 to $207 268]). The probability that HaH is cost saving was 69.2%. Compared with inpatient care, ACT used 15% less nursing time (296 minutes, 95% UI, 257 to 335 minutes) and 50% less medical time (57 minutes, 95% UI, 46 to 69 minutes) per case of chest pain. If implemented nationally, ACT would save an estimated 1 561 185 SGD per year (95% UI, 1 040 666 to 2 086 518 SGD [US $1 149 862; 95% UI, $766 483 to $1 536 786]). The probability that ACT is cost saving was 100%.Conclusions and RelevanceThis economic evaluation found that the HaH and ACT models decreased the overall personnel cost of care. Reorganizing hospital resources may help hospitals reap the benefits of reduced hospital-acquired infections, improved patient recovery, and reduced hospital bed occupancy rates.

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Section: Introductionmentioning

confidence: 79%

Section: Introductionmentioning

confidence: 99%

Economic Evaluation of Novel Models of Care for Patients With Acute Medical Problems

Goh,

Xin,

Lim

et al. 2023

JAMA Netw Open

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“…However, both clinician and patient perceptions of its acceptability remain unevaluated. 41,42 There is potential to utilise this technology to aid training geared towards CiP 3 (manages ward rounds and ongoing care of inpatients) with remote supervision of ward rounds or multiple ward rounds if trainees are competent to act with indirect supervision.…”

Section: Potential Solutionsmentioning

confidence: 99%

Future of Surgery: Technology Enhanced Surgical Training: Report of the FOS:TEST Commission

Adebayo¹,

Aldoori²,

Allum³

et al. 2022

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Over the past 50 years the capability of technology to improve surgical care has been realised and while surgical trainees and trainers strive to deliver care and train; the technological ‘solutions’ market continues to expand. However, there remains no coordinated process to assess these technologies. The FOS:TEST Report aimed to (1) define the current, unmet needs in surgical training, (2) assess the current evidence-base of technologies that may be beneficial to training and map these onto both the patient and trainee pathway and (3) make recommendations on the development, assessment, and adoption of novel surgical technologies. The FOS:TEST Commission was formed by the Association of Surgeons in Training (ASiT), The Royal College of Surgeons of England (RCS England) Robotics and Digital Surgery Group and representatives from all trainee specialty associations. Two national datasets provided by Health Education England were used to identify unmet surgical training needs through qualitative analysis against pre-defined coding frameworks. These unmet needs were prioritised at two virtual consensus hackathons and mapped to the patient and trainee pathway and the capabilities in practice (CiPs) framework. The commission received more than 120 evidence submissions from surgeons in training, consultant surgeons and training leaders. Following peer review, 32 were selected that covered a range of innovations. Contributors also highlighted several important key considerations, including the changing pedagogy of surgical training, the ethics and challenges of big data and machine learning, sustainability, and health economics. This summates to 7 Key Recommendations and 51 concluding statements. The FOS:TEST Commission was borne out of what is a pivotal point in the digital transformation of surgical training. Academic expertise and collaboration will be required to evaluate efficacy of any novel training solution. However, this must be coupled with pragmatic assessments of feasibility and cost to ensure that any intervention is scalable for national implementation. Currently, there is no replacement for hands-on operating. However, for future UK and ROI surgeons to stay relevant in a global market, our training methods must adapt. The Future of Surgery: Technology Enhanced Surgical Training Report provides a blueprint for how this can be achieved.

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Pandemic insights: what COVID-19 has revealed about traditional rounding structure

Czapka,

Lehmann

2023

Discov Soc Sci Health

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Due to social distancing policies and concerns over patient and provider safety, early in the COVID-19 pandemic many healthcare institutions temporarily converted to various, non-traditional rounding models. The abrupt and unprecedented change in workflow has enabled re-assessment of the reasons for the traditional rounding structures in medical education and comparison to newer strategies for rounding which have developed out of necessity during the pandemic. In this Perspectives article, we examine the positive and negative aspects of rounding models borne out of the pandemic and suggest aspects which may be carried forward, as well as future directions for research.

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Perception and Acceptability of Virtual Ward Round Reviews of Vascular Inpatients to Preserve Resources and Reduce Infection Risk in the COVID-19 Era

Cited by 5 publications

References 5 publications

Economic Evaluation of Novel Models of Care for Patients With Acute Medical Problems

Economic Evaluation of Novel Models of Care for Patients With Acute Medical Problems

Future of Surgery: Technology Enhanced Surgical Training: Report of the FOS:TEST Commission

Pandemic insights: what COVID-19 has revealed about traditional rounding structure

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