Objective: Government targets to reduce waiting times are putting enormous pressures on outpatient services. The implementation of an electronic care records service (CRS) at our hospital in 2008 has led to widespread...Objective: Government targets to reduce waiting times are putting enormous pressures on outpatient services. The implementation of an electronic care records service (CRS) at our hospital in 2008 has led to widespread press coverage of ensuing chaos in clinical administration. We wanted to know how this new electronic system impacted on our working patterns in outpatient clinics and – more specifically – on the time actually spent with the patients. Material & methods: This study was performed 4 and 12 months after implementation of CRS to assess its impact on the time distribution in clinic. Senior doctors were monitored with a stop clock during consultations. Timings for pre- and post-consultation administration, and the actual consultation with the patient were recorded. A total of 170 consultations were evaluated in this way. Results: The key findings were that the total time needed to spend on a urological outpatient of 16 minutes remains unchanged from the pre-CRS era, but a majority (57%) of this time is spent in administration on the computer without the patient involved. Conclusion: No more than 15 patients should be seen in a 4 hour outpatient clinic per doctor. This recommendation drawn up by BAUS before CRS remains still valid. Patient administration related to the consultation that has previously been done by administrative aides is now to be done by the doctors on the computer in the same consultation session. Intended to streamline patient pathways, this does reduce the quality interaction-time between doctor and patients significantly.展开更多
Background: Occupational noise can induce hearing impairment. Work-related hearing impairment has become a growing threat to medical practitioners who feel anxious about occupational noise exposure and its health outc...Background: Occupational noise can induce hearing impairment. Work-related hearing impairment has become a growing threat to medical practitioners who feel anxious about occupational noise exposure and its health outcomes or even experience auditory dysesthesia (including drumming, distending pain in the ears, and otalgia) after long-term exposure to a noisy work environment. Objective: To investigate the effects of occupational noise on the hearing ability of outpatient clinic nurses in Grade III, Level A and Grade II, Level A hospitals in Guangzhou. Methods: During June 2019, noise monitoring was performed by quantifying the noise levels at four measuring points (reception, waiting area, hallway, blood-sampling room) in five Grade III, Level A and five Grade II, Level A hospitals, in Guangzhou, four times a day (8 AM, 10 AM, 2 PM, and 4 PM) for 19 working days, using a professional noise measuring application for smartphones. The measurements were verified and used to create a database in Excel. Data analysis was conducted using SPSS22.0, and questionnaires were distributed to nurses who had been working at outpatient clinics for five years and above to assess the impacts of occupational noise exposure on the hearing ability. Results: In the Grade III, Level A hospitals, the sound levels at the four measuring points during the specific time periods were 4.92 - 6.75 dB above the permissible limit of 55 dB and were all significantly higher than the sound levels at the outpatient clinics of the Grade II, Level A hospitals (P Conclusions: Exposure to excess noise can lead to auditory dysesthesia in outpatient clinic nurses. Compared to those from Grade II, Level A hospitals, outpatient clinic nurses from Grade III, Level A hospitals are at higher risk of auditory dysesthesia. The noise levels at outpatient clinics should be closely monitored, and effective measures should be taken to reduce occupational noise exposure. Outpatient clinic nurses should enhance protective measures and receive preventive health exams on a regular basis.展开更多
<strong>Background:</strong> To make outpatient visits for adolescents with diabetes successful, it is important for health care professionals to meet the adolescents’ needs and wishes. <strong>Aims...<strong>Background:</strong> To make outpatient visits for adolescents with diabetes successful, it is important for health care professionals to meet the adolescents’ needs and wishes. <strong>Aims:</strong> The aim is to investigate adolescents’ expectations of an outpatient diabetes clinic visit in comparison to what was deemed to be delivered and contrast this outcome in adolescents with self-reported high- and low-diabetes distress respectively. <strong>Methods:</strong> All adolescents in Sweden with type 1 diabetes, aged 15 to 18 years, were identified via The National Pediatric Diabetes Registry (SWEDIABKIDS) and asked to complete an online questionnaire regarding their expectations and the support received during the outpatient diabetes clinic visit. <strong>Results:</strong> 453 adolescents completed the survey. Boys’ expectations of discussion topics were mainly met while girls, especially those with diabetes distress, felt their discussion needs were not met regarding quality-of-life aspects. <strong>Conclusions:</strong> Although adolescents’ expectations are in general met during the diabetes outpatient clinic visit, aspects related to living with diabetes are not being met especially among female adolescents who reported diabetes distress. This study shows a gender difference both regarding expected discussion topics and what was deemed covered. <strong>Practice Implications:</strong> A multi-professional, individual person-centred care approach is needed at the diabetes outpatient clinic. This paper proposes that agenda setting performed by the adolescent, and agreed by the physician, prior to the outpatient clinic visit could facilitate individualized care and better meet the adolescents’ needs in a shared decision-making process.展开更多
目的:探讨精细化管理在儿童发热门诊输液流程中的应用效果。方法:选取2022年3月1日—6月30日在江西省儿童医院发热门诊进行静脉输液治疗的300例患儿作为对照组(实施常规管理),选取2022年7月1日—10月31日在江西省儿童医院发热门诊进行...目的:探讨精细化管理在儿童发热门诊输液流程中的应用效果。方法:选取2022年3月1日—6月30日在江西省儿童医院发热门诊进行静脉输液治疗的300例患儿作为对照组(实施常规管理),选取2022年7月1日—10月31日在江西省儿童医院发热门诊进行静脉输液治疗的300例患儿作为观察组(实施精细化管理)。比较两组患儿发热门诊诊疗时间、输液等待时间,家长满意度,护士输液工作职业倦怠感[职业倦怠感调查普适量表(Maslach burnout inventory general survey,MBI-GS)]。结果:观察组患儿发热门诊诊疗时间、输液等待时间短于对照组,家长总满意度高于对照组,护士MBI-GS的情绪疲惫感、工作冷漠感、成就感低落得分均低于对照组,差异有统计学意义(P<0.05)。结论:儿童发热门诊输液流程中应用精细化管理,能缩短患儿发热门诊诊疗时间和输液等待时间,提高家长满意度,降低护士职业倦怠感。展开更多
文摘Objective: Government targets to reduce waiting times are putting enormous pressures on outpatient services. The implementation of an electronic care records service (CRS) at our hospital in 2008 has led to widespread press coverage of ensuing chaos in clinical administration. We wanted to know how this new electronic system impacted on our working patterns in outpatient clinics and – more specifically – on the time actually spent with the patients. Material & methods: This study was performed 4 and 12 months after implementation of CRS to assess its impact on the time distribution in clinic. Senior doctors were monitored with a stop clock during consultations. Timings for pre- and post-consultation administration, and the actual consultation with the patient were recorded. A total of 170 consultations were evaluated in this way. Results: The key findings were that the total time needed to spend on a urological outpatient of 16 minutes remains unchanged from the pre-CRS era, but a majority (57%) of this time is spent in administration on the computer without the patient involved. Conclusion: No more than 15 patients should be seen in a 4 hour outpatient clinic per doctor. This recommendation drawn up by BAUS before CRS remains still valid. Patient administration related to the consultation that has previously been done by administrative aides is now to be done by the doctors on the computer in the same consultation session. Intended to streamline patient pathways, this does reduce the quality interaction-time between doctor and patients significantly.
文摘Background: Occupational noise can induce hearing impairment. Work-related hearing impairment has become a growing threat to medical practitioners who feel anxious about occupational noise exposure and its health outcomes or even experience auditory dysesthesia (including drumming, distending pain in the ears, and otalgia) after long-term exposure to a noisy work environment. Objective: To investigate the effects of occupational noise on the hearing ability of outpatient clinic nurses in Grade III, Level A and Grade II, Level A hospitals in Guangzhou. Methods: During June 2019, noise monitoring was performed by quantifying the noise levels at four measuring points (reception, waiting area, hallway, blood-sampling room) in five Grade III, Level A and five Grade II, Level A hospitals, in Guangzhou, four times a day (8 AM, 10 AM, 2 PM, and 4 PM) for 19 working days, using a professional noise measuring application for smartphones. The measurements were verified and used to create a database in Excel. Data analysis was conducted using SPSS22.0, and questionnaires were distributed to nurses who had been working at outpatient clinics for five years and above to assess the impacts of occupational noise exposure on the hearing ability. Results: In the Grade III, Level A hospitals, the sound levels at the four measuring points during the specific time periods were 4.92 - 6.75 dB above the permissible limit of 55 dB and were all significantly higher than the sound levels at the outpatient clinics of the Grade II, Level A hospitals (P Conclusions: Exposure to excess noise can lead to auditory dysesthesia in outpatient clinic nurses. Compared to those from Grade II, Level A hospitals, outpatient clinic nurses from Grade III, Level A hospitals are at higher risk of auditory dysesthesia. The noise levels at outpatient clinics should be closely monitored, and effective measures should be taken to reduce occupational noise exposure. Outpatient clinic nurses should enhance protective measures and receive preventive health exams on a regular basis.
文摘<strong>Background:</strong> To make outpatient visits for adolescents with diabetes successful, it is important for health care professionals to meet the adolescents’ needs and wishes. <strong>Aims:</strong> The aim is to investigate adolescents’ expectations of an outpatient diabetes clinic visit in comparison to what was deemed to be delivered and contrast this outcome in adolescents with self-reported high- and low-diabetes distress respectively. <strong>Methods:</strong> All adolescents in Sweden with type 1 diabetes, aged 15 to 18 years, were identified via The National Pediatric Diabetes Registry (SWEDIABKIDS) and asked to complete an online questionnaire regarding their expectations and the support received during the outpatient diabetes clinic visit. <strong>Results:</strong> 453 adolescents completed the survey. Boys’ expectations of discussion topics were mainly met while girls, especially those with diabetes distress, felt their discussion needs were not met regarding quality-of-life aspects. <strong>Conclusions:</strong> Although adolescents’ expectations are in general met during the diabetes outpatient clinic visit, aspects related to living with diabetes are not being met especially among female adolescents who reported diabetes distress. This study shows a gender difference both regarding expected discussion topics and what was deemed covered. <strong>Practice Implications:</strong> A multi-professional, individual person-centred care approach is needed at the diabetes outpatient clinic. This paper proposes that agenda setting performed by the adolescent, and agreed by the physician, prior to the outpatient clinic visit could facilitate individualized care and better meet the adolescents’ needs in a shared decision-making process.
文摘目的:探讨精细化管理在儿童发热门诊输液流程中的应用效果。方法:选取2022年3月1日—6月30日在江西省儿童医院发热门诊进行静脉输液治疗的300例患儿作为对照组(实施常规管理),选取2022年7月1日—10月31日在江西省儿童医院发热门诊进行静脉输液治疗的300例患儿作为观察组(实施精细化管理)。比较两组患儿发热门诊诊疗时间、输液等待时间,家长满意度,护士输液工作职业倦怠感[职业倦怠感调查普适量表(Maslach burnout inventory general survey,MBI-GS)]。结果:观察组患儿发热门诊诊疗时间、输液等待时间短于对照组,家长总满意度高于对照组,护士MBI-GS的情绪疲惫感、工作冷漠感、成就感低落得分均低于对照组,差异有统计学意义(P<0.05)。结论:儿童发热门诊输液流程中应用精细化管理,能缩短患儿发热门诊诊疗时间和输液等待时间,提高家长满意度,降低护士职业倦怠感。
