Search results for "After-Hours Care"

showing 9 items of 9 documents

Role of out of hours primary care service in limiting inappropriate access to emergency department

2017

Out of hours (OOH) doctors can have an important gate-keeping role over the access to the emergency department (ED), but the outcome and the quality of their ED referrals have been poorly studied. We aimed to investigate the outcome of patients referred to ED from OOH service and the determinants of admission or short-stay dispositions. We collected retrospectively data about referrals to ED from a local OOH service in the north-east of Italy using the OOH paper register and the ED electronic database, over the period of 01/10/2012 to 31/03/2013. Out of 5217 patients accessing the OOH service, 408 referrals were included in our analysis. 45.3% (185) of the referrals were admitted to hospita…

AdultMalemedicine.medical_specialtyPalliative careAdolescentNational Health ProgramsReferralPsychological interventionPrimary careconsultation AppropriatenessAfter-hours care03 medical and health sciencesGate keeping0302 clinical medicineOut of hoursInternal MedicineHumansMedicineAppropriateness030212 general & internal medicineChildAgedRetrospective StudiesAfter-hours care; Appropriateness; Emergency service; Gate keeping; Primary health care; Referral and consultation; Internal Medicine; Emergency MedicinePrimary health careEmergency service Gate keeping Referral andService (business)business.industry030503 health policy & servicesReferral and consultationLimitingEmergency departmentMiddle AgedItalyChild PreschoolEmergency medicineEmergency MedicineAfter-hours care Primary health careFemaleEmergency Service Hospital0305 other medical sciencebusinessEmergency serviceInternal and Emergency Medicine
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Associations between structures, processes and outcomes in inter-municipal cooperation in out-of-hours services in Norway: A survey study

2020

Abstract Inter-municipal cooperation (IMC) has gained widespread recognition as a beneficial strategy for improving efficiency and quality in the provision of out-of-hours emergency care services (OOH services). Little attention, however, has been given to the additional costs of cooperation and the relational processes through which benefits and costs are likely to result. Based on survey data from 266 (77%) Norwegian municipalities involved in IMC in OOH services in 2015, this study aimed to investigate how the structure (governance form, complexity and stability) and quality (trust and consensus) of cooperation processes interact to influence the perceived outcomes (benefits and costs) o…

Emergency Medical ServicesHealth (social science)media_common.quotation_subjectStructural equation modeling03 medical and health sciences0302 clinical medicineOut of hoursAfter-Hours CareHistory and Philosophy of ScienceSurveys and QuestionnairesHumansQuality (business)030212 general & internal medicinemedia_commonPublic economicsNorway030503 health policy & servicesCorporate governanceSurvey researchVDP::Medisinske Fag: 700::Idrettsmedisinske fag: 850Peer reviewInter-municipal cooperationVDP::Medisinske Fag: 700::Helsefag: 800Survey data collectionBusiness0305 other medical scienceSocial Science & Medicine
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Association between night-time surgery and occurrence of intraoperative adverse events and postoperative pulmonary complications

2019

WOS: 000458513600019

Lung DiseasesPostoperative Complications/epidemiologyMaleInternationalityIntraoperative Complicationmedicine.medical_treatmentSettore MED/41 - Anestesiologia[SDV.MHEP.PSR]Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tractLung DiseaseCohort StudiesBIOMEDICINA I ZDRAVSTVO. Kliničke medicinske znanosti. Anesteziologija i reanimatologija.0302 clinical medicine030202 anesthesiologyRisk Factorspatient safetyMedicineGeneral anaesthesiapostoperative complicationProspective Studiesintraoperative complicationsStatistics & numerical dataProspective cohort studyIncidence (epidemiology)Incidencegeneral anaesthesia intraoperative complications patient safety postoperative complications pulmonaryMiddle AgedOperative3. Good healthSurgical Procedures OperativeFemalegeneral anaesthesia ; intraoperative complications ; patient safety ; postoperative complications ; pulmonaryCohort studyHumanAdultmedicine.medical_specialtypulmonaryLung Diseases/epidemiology[SDV.MHEP.CHI]Life Sciences [q-bio]/Human health and pathology/SurgeryNO03 medical and health sciencesgeneral anaesthesia; intraoperative complications; patient safety; postoperative complications; pulmonary;Intraoperative Complications/epidemiologyAfter-Hours Carepostoperative complicationsHumansgeneral anaesthesiaMED/41 - ANESTESIOLOGIAAdverse effectAgedMechanical ventilationSurgical Proceduresbusiness.industryRisk FactorBIOMEDICINE AND HEALTHCARE. Clinical Medical Sciences. Anesthesiology and Reanimatology.intraoperative complicationSurgeryAfter-Hours Care/statistics & numerical datageneral anaesthesia; intraoperative complications; patient safety; postoperative complications; pulmonary; Anesthesiology and Pain MedicineClinical trialMESH: After-hours Care / statistics & numerical data; Lung diseases / epidemiology; Surgical procedures operativeProspective StudieAnesthesiology and Pain Medicine[SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologieCohort Studiebusiness
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On versus off-hour care of patients with acute coronary syndrome and persistent ST-segment elevation in certified German chest pain units

2016

BACKGROUND Regional healthcare projects improve the off-hour care of patients with acute coronary syndromes and persistent ST-segment elevation myocardial infarction (STEMI). To analyse differences in quality of care between on and off-hour care of STEMI patients admitted to certified German chest pain units. METHODS A total of 1107 STEMI patients from the German chest pain unit registry were enrolled. Analyses comprised critical time intervals (symptoms to first medical contact (FMC), FMC to admission, symptoms to admission, symptoms to balloon, FMC to balloon, door to balloon times) and major adverse cardiac and cerebrovascular events at follow-up. RESULTS 54.8% of patients were admitted …

MaleAcute coronary syndromePercutaneousmedicine.medical_treatmentMedizin030204 cardiovascular system & hematologyCritical Care and Intensive Care MedicineBioinformaticsBalloonChest painTime-to-Treatment03 medical and health sciences0302 clinical medicineAfter-Hours CareGermanyMyocardial RevascularizationmedicineHumansST segment030212 general & internal medicineMyocardial infarctionAcute Coronary SyndromeAngioplasty Balloon CoronaryAgedbusiness.industryPercutaneous coronary interventionGeneral MedicineMiddle Agedmedicine.diseaseAnesthesiaDoor-to-balloonST Elevation Myocardial InfarctionFemalemedicine.symptomCardiology and Cardiovascular Medicinebusiness
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Predictors of emergency department referral in patients using out-of-hours primary care services

2016

Background Out of hours (OOH) doctors could manage many cases limiting the inappropriate accesses to ED. However the possible determinants of referral to ED by OOH doctors are poorly studied. We aimed to characterize patients referred from the OOH to ED service in order to explore the gate-keeping role of OOH service for hospital emergency care and to facilitate future research in improving its cost-effectiveness. Methods A retrospective study was made through data collection of 5217 contacts in a local OOH service in the North-East of Italy (from 10/01/2012 to 03/31/2013). Results Only 8.7% (=454 people) of the total contacts were referred to ED. In the multivariate analysis, the significa…

MaleMultivariate analysisReferralPopulationContext (language use)Emergency department; Gate-keeping; Out-of-hours primary careHealth Services AccessibilityOut-of-hours primary care03 medical and health sciences0302 clinical medicineAfter-Hours CareGate-keepingHumansMedicine030212 general & internal medicineeducationReferral and ConsultationRetrospective Studieseducation.field_of_studyPrimary Health Carebusiness.industryEmergency department030503 health policy & servicesHealth PolicyAge FactorsRetrospective cohort studyOvercrowdingEmergency departmentOdds ratioMiddle Agedmedicine.diseaseNursing HomesItalyFemaleMedical emergencyEmergency Service Hospital0305 other medical sciencebusiness
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The safety attitudes questionnaire for out-of-hours service in primary healthcare—Psychometric properties of the Croatian version

2020

The aim of the study was to assess the reliability and construct validity of the Croatian trans- lation of the Safety Attitudes Questionnaire—Ambulatory version (SAQ-AV) in the out-of- hours (OOH) primary care setting. A cross-sectional observational study using anonymous web-survey was carried out targeting a convenience sample of 358 health professionals working in the Croatian OOH primary care service. The final sample consisted of 185 questionnaires (response rate 51.7%). Psychometric properties were assessed using exploratory hierarchical factor analysis with Schmid-Leiman rotation to bifactor solution, McDonald’s ω, and Cronbach’s α. Five group factors were identified: Organization cl…

MaleQuestionnairesCritical Care and Emergency MedicineEconomicsHealth Care ProvidersSocial SciencesMathematical and Statistical TechniquesPsychological AttitudesSurveys and QuestionnairesMedicine and Health SciencesPsychologymedia_commonAllied Health Care ProfessionalsTeamworkMultidisciplinaryQStatisticsRWorkloadMiddle AgedOrganisation climateResearch DesignPhysical SciencesOut-of-hours Safety attitudes questionnaire Primary care Patient safety culture Quality improvement Adverse events Medical errorsMedicineJob satisfactionFemalePatient SafetyPsychologyFactor AnalysisClinical psychologyResearch ArticleAdultEmploymentPsychometricsCroatiaSciencemedia_common.quotation_subjectHealth PersonnelPasientsikkerheteducationJobsResearch and Analysis MethodsJob SatisfactionPatient safetyCronbach's alphaAfter-Hours CareHumansStatistical MethodsPrimary CareAgedSurvey ResearchPrimary Health CareConstruct validityBiology and Life SciencesTranslatingPsykometriHealth CareCross-Sectional StudiesLabor EconomicsObservational studyFactor Analysis StatisticalMathematics
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Turning a new “page”: ways to decrease the number of pages after hours without compromising patient care

2020

Pages to house staff after hours, especially overnight, lead to interrupted sleep and fatigue the next day. Although some pages are urgent, others may not need an immediate response. In this study we aimed to identify unwarranted pages and to establish ways to reduce them.Over 2 months, all pages to the Department of Pediatric Urology at the Hospital for Sick Children in Toronto, Canada, during call hours were documented, including the assessment of the responding physicians of their medical necessity. After analyzing the reasons for inappropriate pages, we took several steps to try to reduce them without impairing patient care. One year later, pages were tracked again to evaluate the effic…

ParentsCanadamedicine.medical_specialtyUrologyMEDLINEPsychological interventionPharmacyWorkloadEfficiency OrganizationalAfter-Hours CarePatient Education as TopicPhoneHumansMedicineFellowships and Scholarshipsbusiness.industryCommunicationResearchInternship and ResidencyWorkloadEmergency departmentHospitals Pediatricmedicine.diseasePediatric urologyrestrictSurgeryHospital Communication SystemsMedical emergencybusinessCanadian Journal of Surgery
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[Analysis of patient safety culture in an out of hours primary care service.]

2020

Background: Aim of this study, part of a European collaborative research project, was to evaluate the "patient safety culture" (PSC) in a primary care out of hours service in order to provide the management with a baseline for improvement interventions. Methods: Cross sectional study with the administration of the Safety Attitude Questionnaire Ambulatory Version (SAQ-AV) administered to all the 56 doctors working out of hours in the ULSS 20 Verona Local Health Trust in April/May 2015. For each item of the questionnaire the average score, standard deviation, non-applicability, percentage of agreement, percentage of disagreement were calculated. Results: Doctors working out of hours appreciat…

Safety ManagementPrimary Health CareAttitude of Health PersonnelContinuity of patient carepersonnel managementOrganizational CultureCross-Sectional StudiesAfter-Hours CareContinuity of patient care job satisfaction patient safety personnel managementcontinuità assistenzialeSurveys and Questionnairespatient safetyHumansjob satisfaction
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Association between night/after-hours surgery and mortality: a systematic review and meta-analysis

2020

Abstract Background The association between night/after-hours surgery and patients' mortality is unclear. Methods The protocol of this systematic review was registered in PROSPERO (CRD42019128534). We searched Medline, PubMed, and EMBASE from inception until August 29, 2019 for studies examining an association between timing of surgical procedures (time of anaesthesia induction or surgery start) and mortality (within 30 days or in-hospital) in adult patients. Studies reporting patients' mortality after surgery performed during the weekend only were excluded. All analyses were done using the random-effects model. Results We included 40 observational studies (36 retrospective and four prospec…

medicine.medical_specialtyMEDLINERisk AssessmentSensitivity and SpecificitysurgeryPatient safetyPostoperative ComplicationsAfter-Hours CareBiasnighttimepatient safetyRisk of mortalityHumansMedicineperioperativePropensity Scorebusiness.industryanaesthesiaOdds ratioPerioperativemortalityConfidence intervalSurgeryTreatment OutcomeAnesthesiology and Pain MedicineSurgical Procedures OperativeMeta-analysisoutcomeObservational studybusinessBritish Journal of Anaesthesia
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