Completion of hand-written surgical consent forms is often suboptimal, with missing or inaccurate patient details, variability in documenting procedure details between forms, and missing potential complications. An audit found 10% of patient details, 30% of procedure details, and 27% of patient signatures were incorrectly filled out on handwritten forms. Electronically generated, procedure-specific consent forms addressed these issues, with no errors found in the forms tested. They provide consistent documentation of procedure details and complications.
The document outlines various workflows for different services at a medical facility called Medi-Infotec. It describes patient flows for outpatient and inpatient services including appointments, consultations, admissions, discharges and billing. It also maps out workflows for specific departments like laboratory, radiology, OT, pharmacy, inventory management, credit notes and returns.
This document is a resume for Lindsey C. Macintire seeking a career as a Medical Laboratory Technician. It outlines her education including an A.A.S. in Medical Laboratory Technology from Delaware Technical Community College in 2015. It also details her relevant clinical rotation experience in areas such as clinical chemistry, hematology, urinalysis, blood bank, microbiology, and serology. Finally, it lists awards, affiliations, and previous work experience as a cleaner at Lewes Yacht Club.
This document provides an overview of lesson 1 of an online phlebotomy module. It discusses the history and evolution of phlebotomy, including how the practice originated in ancient Egypt. It also outlines several major phlebotomy organizations that professionals can receive certification from, such as the American Certification Agency and the National Certification Agency. The responsibilities of phlebotomists are explained, such as properly identifying patients, maintaining professionalism, and providing good customer service. Additional regulating agencies beyond the certification organizations, like the CDC and OSHA, are also summarized. The lesson concludes with a section about HIPAA and protecting patient privacy.
The document discusses a quality improvement project at Northampton General Hospital to identify areas for improving the management of patients in the hospital's "hot surgical clinic". The clinic was intended to reduce burdens on the emergency department and avoid unnecessary admissions. During a 3-month review, some issues were identified, including patients sometimes being referred inappropriately, overcrowding in the surgical assessment area, and lack of senior support and documentation. Improving adherence to guidelines on inclusion/exclusion criteria, ensuring reliable senior support, and developing local guidelines could help address these issues and better manage patients in the hot surgical clinic.
This document discusses the costs of medical errors and efforts to reduce preventable hospital-acquired conditions (HACs). It notes that medical errors may cause up to 98,000 deaths per year costing up to $29 billion annually. Hospitals have little incentive to improve safety due to externalizing most error costs. In response, policies began denying Medicare/Medicaid payments for treatments from certain HACs considered preventable. This policy was expanded in 2012/2015 and may reduce payments to hospitals with the highest rates of HACs. The goal is to incentivize greater patient safety.
Whitepaper: Hospital Operations Management reduces wait states and replaces d...GE Software
No Wait States … in pursuit of the frictionless patient experience. Electronic health records have fallen short. Patients continue to wait. Costs remain high. Why focusing on operational management can help hospitals make things right … starting now.
The document discusses recent advances in safer surgery. It defines safer surgery as reducing avoidable harm to surgical patients. Common causes of patient harm include errors by healthcare professionals, a complex healthcare system, and barriers during care. Standards, communication, and learning from incidents can help achieve safer surgery goals. The WHO surgical safety checklist provides a standardized 5-step process of briefing, sign in, time out, sign out, and debriefing to reduce errors and improve outcomes. Implementing changes gradually through repeated testing and feedback cycles allows for safer surgery initiatives to be successfully adopted.
This case report discusses 3 cases of fatalities that occurred during or after dental treatment and examines the importance of accurate diagnosis and understanding a patient's medical conditions. The cases included a patient who had a stroke after a tooth extraction, another who had undiagnosed leukemia, and a third who experienced sudden cardiac arrest during a procedure. Proper patient history, examination, and risk assessment are crucial to prevent fatalities, as dental procedures can expose underlying medical problems. An improved understanding of patient health statuses and risks can help practitioners provide safe care and recommend treatment appropriately.
The document outlines various workflows for different services at a medical facility called Medi-Infotec. It describes patient flows for outpatient and inpatient services including appointments, consultations, admissions, discharges and billing. It also maps out workflows for specific departments like laboratory, radiology, OT, pharmacy, inventory management, credit notes and returns.
This document is a resume for Lindsey C. Macintire seeking a career as a Medical Laboratory Technician. It outlines her education including an A.A.S. in Medical Laboratory Technology from Delaware Technical Community College in 2015. It also details her relevant clinical rotation experience in areas such as clinical chemistry, hematology, urinalysis, blood bank, microbiology, and serology. Finally, it lists awards, affiliations, and previous work experience as a cleaner at Lewes Yacht Club.
This document provides an overview of lesson 1 of an online phlebotomy module. It discusses the history and evolution of phlebotomy, including how the practice originated in ancient Egypt. It also outlines several major phlebotomy organizations that professionals can receive certification from, such as the American Certification Agency and the National Certification Agency. The responsibilities of phlebotomists are explained, such as properly identifying patients, maintaining professionalism, and providing good customer service. Additional regulating agencies beyond the certification organizations, like the CDC and OSHA, are also summarized. The lesson concludes with a section about HIPAA and protecting patient privacy.
The document discusses a quality improvement project at Northampton General Hospital to identify areas for improving the management of patients in the hospital's "hot surgical clinic". The clinic was intended to reduce burdens on the emergency department and avoid unnecessary admissions. During a 3-month review, some issues were identified, including patients sometimes being referred inappropriately, overcrowding in the surgical assessment area, and lack of senior support and documentation. Improving adherence to guidelines on inclusion/exclusion criteria, ensuring reliable senior support, and developing local guidelines could help address these issues and better manage patients in the hot surgical clinic.
This document discusses the costs of medical errors and efforts to reduce preventable hospital-acquired conditions (HACs). It notes that medical errors may cause up to 98,000 deaths per year costing up to $29 billion annually. Hospitals have little incentive to improve safety due to externalizing most error costs. In response, policies began denying Medicare/Medicaid payments for treatments from certain HACs considered preventable. This policy was expanded in 2012/2015 and may reduce payments to hospitals with the highest rates of HACs. The goal is to incentivize greater patient safety.
Whitepaper: Hospital Operations Management reduces wait states and replaces d...GE Software
No Wait States … in pursuit of the frictionless patient experience. Electronic health records have fallen short. Patients continue to wait. Costs remain high. Why focusing on operational management can help hospitals make things right … starting now.
The document discusses recent advances in safer surgery. It defines safer surgery as reducing avoidable harm to surgical patients. Common causes of patient harm include errors by healthcare professionals, a complex healthcare system, and barriers during care. Standards, communication, and learning from incidents can help achieve safer surgery goals. The WHO surgical safety checklist provides a standardized 5-step process of briefing, sign in, time out, sign out, and debriefing to reduce errors and improve outcomes. Implementing changes gradually through repeated testing and feedback cycles allows for safer surgery initiatives to be successfully adopted.
This case report discusses 3 cases of fatalities that occurred during or after dental treatment and examines the importance of accurate diagnosis and understanding a patient's medical conditions. The cases included a patient who had a stroke after a tooth extraction, another who had undiagnosed leukemia, and a third who experienced sudden cardiac arrest during a procedure. Proper patient history, examination, and risk assessment are crucial to prevent fatalities, as dental procedures can expose underlying medical problems. An improved understanding of patient health statuses and risks can help practitioners provide safe care and recommend treatment appropriately.
Though a recent study found repeat colonoscopy is good for certain patients, accurate documentation is still a crucial factor to determine whether it is appropriate.
Abstract- Because of the complexity of the procedures, high level of clarification for the patients as well as their attendants while taking consent is a must as cardiac surgery is associated with significant morbidity and mortality. Pictorial consent with pre-operative education is a far better option in this regard. We randomly took a total of 150 patients within the age group of 18 to 70 years, and they were explained with standard consent followed by pictorial consent and vice versa by the same informant. And they were given a preset questionnaire format after both consents. Later, based on their answers, comparison in relation to the level of clarity was done. Questionnaire was formatted after rigorous modification from the reviews of literature.
The document discusses the pros and cons of implementing electronic health records (EHRs) in hospitals and healthcare facilities. Some key benefits discussed include improved data accessibility, computerized physician order entry, improved charge capture, and opportunities for preventative health screenings. However, the document also notes several challenges, such as increased time spent on documentation, costs of setup and maintenance, decreased productivity during implementation, and issues with a lack of interoperability between different EHR systems. Overall, the document provides an overview of the debate around whether the benefits of EHRs outweigh the drawbacks.
This document discusses strategies for standardizing handoff processes throughout healthcare organizations. It explains that standardizing handoffs is challenging but important for patient safety, as ineffective handoffs can lead to medical errors and other issues. The document outlines some key steps for organizations to take, such as developing and implementing a standardized process, obtaining leadership and staff buy-in, and addressing hierarchical relationships among staff that can hinder communication. Standardizing handoffs requires significant cultural change across an entire organization.
This document summarizes a report by the National Ethics Committee of the Veterans Health Administration about the fundamentals of ethical online messaging between patients and clinicians. It finds that while online messaging could improve care by enhancing communication, it also raises concerns about privacy, effects on relationships, and clinicians' workload. The report offers seven recommendations to help ensure the ethical practice of online messaging within VHA, including ensuring privacy and security, making participation voluntary, informing patients, and recognizing online interactions as part of clinicians' work.
Nec report 20040701_online_clinician-pt_messaging-1Michelle Breaux
This document summarizes a report by the National Ethics Committee of the Veterans Health Administration on the fundamentals of ethical online patient-clinician messaging. The report examines the benefits and challenges of online communication between patients and clinicians. It makes seven recommendations to ensure the ethical practice of online messaging within VHA, including ensuring patient privacy and security, voluntary participation for patients and clinicians, and recognition of online interactions as part of clinicians' professional activities. The report provides context on the nature and purposes of online health communication to inform the discussion of ethical challenges.
Can video recording revolutionise medical quality the bmjRob Macadam
This article discusses how video recording medical procedures could improve quality of care and accountability. It notes that a patient unknowingly recorded his colonoscopy and discovered inappropriate behavior by physicians. The article argues that video recording could detect such issues more readily than relying on staff reports. It also suggests video could be used for education, quality reviews, and improving compliance with best practices. Patients generally support the idea of recording procedures. With proper consent and privacy protections, the article concludes video recording has potential to provide a more detailed record of care compared to written notes alone.
This study examined the core predictors of "hassles" experienced by patients with multiple chronic conditions (multimorbidity) in primary care. The researchers surveyed 486 patients with multimorbidity across four general practices in the UK. They found that the most commonly reported hassles related to lack of information about conditions/treatments, poor communication among providers, and poor access to specialists. Having more conditions, symptoms of anxiety/depression, younger age, employment, and no recent discussion with their GP predicted greater hassles. The study highlights key hassles that should be addressed and patient groups most at risk to help design improved models of care for multimorbidity.
This document summarizes a study that assessed the knowledge of surgical errors and attitudes towards surgical safety checklists among surgical team members in Port Said public hospitals. The study found that surgical team members had very good knowledge of surgical errors and good attitudes towards surgical safety checklists. Specifically, 98.2% knew about surgical errors, and 90% stated that checklists improved team communication. However, the study had limitations as the sample size was small and most respondents were nurses from public hospitals. The conclusions recommend increasing training, reporting near misses, and emphasizing team members' safety responsibilities to further reduce errors.
Hth 1304, health information technology and systems 1 jasmin849794
This document provides an overview of various health care settings and their associated health information systems. It describes ambulatory surgical facilities, physician offices, dialysis centers, emergency departments, urgent care facilities, radiology departments, laboratory departments, and hospitals. For each setting it provides a brief description of its functions and characteristics and discusses relevant health information standards, coding systems, and forms used such as ICD-10, HCPCS/CPT, UB-04, and CMS-1500. The document aims to familiarize health information management professionals with how different settings collect, transmit, and analyze patient health information.
Campbell Soup Company faced accusations of improper accounting practices during an audit by PwC. These practices included trade loading, improper accounting for loading discounts, shipping products to warehouses to boost sales, and guaranteed sales. While aware of Campbell's disproportionate end-of-quarter sales, the judge ruled PwC did not need to consider this a red flag as the auditor viewed it as a traditional trend. However, auditors should understand industry practices to determine what is normal versus suspicious financial reporting. The case examines auditor responsibilities to identify potentially fraudulent client activities.
ONLINE PATIENT-CLINICIAN MESSAGING FUNDAMENTALS OF ETH.docxcherishwinsland
This document summarizes a report by the National Ethics Committee of the Veterans Health Administration on the fundamentals of ethical online messaging between patients and clinicians. The summary outlines some key points:
1) Online messaging has potential benefits but also raises ethical concerns regarding privacy, access, effects on relationships, and fairness.
2) It examines the nature of online communication and explores challenges involving privacy/confidentiality, access, impacts on relationships, informed participation, and workload/compensation.
3) The report offers recommendations to assure ethical online messaging within VHA, including ensuring privacy/security, voluntary participation, informed patients, and appropriate uses.
Background: The transition from resident physician to independent practitioner is an important period for young physicians.Optimally, they would feel well prepared to independently care for all patients presenting to them for anesthesia, however, this is unlikely Methods: A survey was emailed to all accredited anesthesiology residency program coordinators in April 2018 for further distribution to their CA3 residents. The survey collected data on the resident’s perception of his or her preparedness to manage a variety of anesthesia cases, patients with comorbid conditions, and ethical issues as well as perform various procedures.
Impact Of Improved Documentation On An Academic Neurosurgical PracticeAntoinette Williams
This document discusses the impact of an educational intervention on documentation accuracy at an academic neurosurgery department. The intervention provided training to physicians on properly documenting patient comorbidities. After the intervention, measures of case complexity including severity of illness, risk of mortality, and case mix index all significantly increased, reflecting more accurate documentation. As a result, the average margin per discharge improved by 42.2%, showing the financial impact of improved documentation. The study demonstrates that targeted training can meaningfully improve documentation quality and its effects on quality metrics and revenue.
This document discusses the importance and standards of clinical documentation. It notes that documentation is important for planning treatment, communication between providers, and providing a single source of truth. Good documentation promotes patient safety, cuts down on duplicative work, and provides a record in case of audits or malpractice claims. The document outlines standards like including patient ID, dates, medical history, allergies and notes the legal aspects of documentation like avoiding erasures, being accurate, and maintaining confidentiality. It discusses the benefits of electronic records for storage and access while noting some financial costs. The purpose of documentation is for planning, organization, coordination and control of health services.
Patient safety is the absence of preventable harm to a patient during the process of health care and reduction of risk of unnecessary harm associated with health.
An infection control nurse informed the PICU consultant that two patients have been found to have MDR Acinetobacter infections. This may constitute an Acinetobacter outbreak. The consultant should confirm it is an outbreak by investigating patients and the environment, calculating the attack rate, and comparing it to the background rate. If confirmed, treatment and prevention measures should be implemented, including isolation, cohorting, strict sterilization and disinfection procedures.
A study was conducted among 1256 dental professionals to assess their knowledge and attitudes regarding conservative and endodontic practices during the COVID-19 pandemic. It was found that while the participants had good basic knowledge of COVID-19, areas for improvement were identified. For example, only 43% knew the accurate incubation period. Rubber dams were recognized as useful by 83% but techniques like low-speed handpieces were preferred by only 25%. While PPE kits were seen as important by 72%, only surgical masks were deemed sufficient by 37%. The study concluded that dental professionals need to be cautious when treating patients during the pandemic and limit disease spread.
A study was conducted among 1256 dental professionals to assess their knowledge and attitudes regarding conservative and endodontic practices during the COVID-19 pandemic. It was found that while the participants had good basic knowledge of COVID-19, areas for improvement were identified. For example, only 43% knew the accurate incubation period. Rubber dams were widely recognized as protective tools, but techniques like low-speed handpieces and chemomechanical methods were less familiar. The study concluded that while dental workers understand disease transmission, extra precautions are needed when treating patients during the pandemic.
Informed consent documents are required to explain clinical trials to participants and obtain their signed agreement to participate. They must include the study purpose, procedures, risks/benefits, alternatives to participation, and participant rights. Case report forms are used to record all required study data for each participant and facilitate data collection, management, and analysis while protecting privacy. The investigator's brochure provides investigators details on the investigational product and guidance for the study based on nonclinical and clinical data.
Cyclothymia Test: Diagnosing, Symptoms, Treatment, and Impact | The Lifescien...The Lifesciences Magazine
The cyclothymia test is a pivotal tool in the diagnostic process. It helps clinicians assess the presence and severity of symptoms associated with cyclothymia.
Though a recent study found repeat colonoscopy is good for certain patients, accurate documentation is still a crucial factor to determine whether it is appropriate.
Abstract- Because of the complexity of the procedures, high level of clarification for the patients as well as their attendants while taking consent is a must as cardiac surgery is associated with significant morbidity and mortality. Pictorial consent with pre-operative education is a far better option in this regard. We randomly took a total of 150 patients within the age group of 18 to 70 years, and they were explained with standard consent followed by pictorial consent and vice versa by the same informant. And they were given a preset questionnaire format after both consents. Later, based on their answers, comparison in relation to the level of clarity was done. Questionnaire was formatted after rigorous modification from the reviews of literature.
The document discusses the pros and cons of implementing electronic health records (EHRs) in hospitals and healthcare facilities. Some key benefits discussed include improved data accessibility, computerized physician order entry, improved charge capture, and opportunities for preventative health screenings. However, the document also notes several challenges, such as increased time spent on documentation, costs of setup and maintenance, decreased productivity during implementation, and issues with a lack of interoperability between different EHR systems. Overall, the document provides an overview of the debate around whether the benefits of EHRs outweigh the drawbacks.
This document discusses strategies for standardizing handoff processes throughout healthcare organizations. It explains that standardizing handoffs is challenging but important for patient safety, as ineffective handoffs can lead to medical errors and other issues. The document outlines some key steps for organizations to take, such as developing and implementing a standardized process, obtaining leadership and staff buy-in, and addressing hierarchical relationships among staff that can hinder communication. Standardizing handoffs requires significant cultural change across an entire organization.
This document summarizes a report by the National Ethics Committee of the Veterans Health Administration about the fundamentals of ethical online messaging between patients and clinicians. It finds that while online messaging could improve care by enhancing communication, it also raises concerns about privacy, effects on relationships, and clinicians' workload. The report offers seven recommendations to help ensure the ethical practice of online messaging within VHA, including ensuring privacy and security, making participation voluntary, informing patients, and recognizing online interactions as part of clinicians' work.
Nec report 20040701_online_clinician-pt_messaging-1Michelle Breaux
This document summarizes a report by the National Ethics Committee of the Veterans Health Administration on the fundamentals of ethical online patient-clinician messaging. The report examines the benefits and challenges of online communication between patients and clinicians. It makes seven recommendations to ensure the ethical practice of online messaging within VHA, including ensuring patient privacy and security, voluntary participation for patients and clinicians, and recognition of online interactions as part of clinicians' professional activities. The report provides context on the nature and purposes of online health communication to inform the discussion of ethical challenges.
Can video recording revolutionise medical quality the bmjRob Macadam
This article discusses how video recording medical procedures could improve quality of care and accountability. It notes that a patient unknowingly recorded his colonoscopy and discovered inappropriate behavior by physicians. The article argues that video recording could detect such issues more readily than relying on staff reports. It also suggests video could be used for education, quality reviews, and improving compliance with best practices. Patients generally support the idea of recording procedures. With proper consent and privacy protections, the article concludes video recording has potential to provide a more detailed record of care compared to written notes alone.
This study examined the core predictors of "hassles" experienced by patients with multiple chronic conditions (multimorbidity) in primary care. The researchers surveyed 486 patients with multimorbidity across four general practices in the UK. They found that the most commonly reported hassles related to lack of information about conditions/treatments, poor communication among providers, and poor access to specialists. Having more conditions, symptoms of anxiety/depression, younger age, employment, and no recent discussion with their GP predicted greater hassles. The study highlights key hassles that should be addressed and patient groups most at risk to help design improved models of care for multimorbidity.
This document summarizes a study that assessed the knowledge of surgical errors and attitudes towards surgical safety checklists among surgical team members in Port Said public hospitals. The study found that surgical team members had very good knowledge of surgical errors and good attitudes towards surgical safety checklists. Specifically, 98.2% knew about surgical errors, and 90% stated that checklists improved team communication. However, the study had limitations as the sample size was small and most respondents were nurses from public hospitals. The conclusions recommend increasing training, reporting near misses, and emphasizing team members' safety responsibilities to further reduce errors.
Hth 1304, health information technology and systems 1 jasmin849794
This document provides an overview of various health care settings and their associated health information systems. It describes ambulatory surgical facilities, physician offices, dialysis centers, emergency departments, urgent care facilities, radiology departments, laboratory departments, and hospitals. For each setting it provides a brief description of its functions and characteristics and discusses relevant health information standards, coding systems, and forms used such as ICD-10, HCPCS/CPT, UB-04, and CMS-1500. The document aims to familiarize health information management professionals with how different settings collect, transmit, and analyze patient health information.
Campbell Soup Company faced accusations of improper accounting practices during an audit by PwC. These practices included trade loading, improper accounting for loading discounts, shipping products to warehouses to boost sales, and guaranteed sales. While aware of Campbell's disproportionate end-of-quarter sales, the judge ruled PwC did not need to consider this a red flag as the auditor viewed it as a traditional trend. However, auditors should understand industry practices to determine what is normal versus suspicious financial reporting. The case examines auditor responsibilities to identify potentially fraudulent client activities.
ONLINE PATIENT-CLINICIAN MESSAGING FUNDAMENTALS OF ETH.docxcherishwinsland
This document summarizes a report by the National Ethics Committee of the Veterans Health Administration on the fundamentals of ethical online messaging between patients and clinicians. The summary outlines some key points:
1) Online messaging has potential benefits but also raises ethical concerns regarding privacy, access, effects on relationships, and fairness.
2) It examines the nature of online communication and explores challenges involving privacy/confidentiality, access, impacts on relationships, informed participation, and workload/compensation.
3) The report offers recommendations to assure ethical online messaging within VHA, including ensuring privacy/security, voluntary participation, informed patients, and appropriate uses.
Background: The transition from resident physician to independent practitioner is an important period for young physicians.Optimally, they would feel well prepared to independently care for all patients presenting to them for anesthesia, however, this is unlikely Methods: A survey was emailed to all accredited anesthesiology residency program coordinators in April 2018 for further distribution to their CA3 residents. The survey collected data on the resident’s perception of his or her preparedness to manage a variety of anesthesia cases, patients with comorbid conditions, and ethical issues as well as perform various procedures.
Impact Of Improved Documentation On An Academic Neurosurgical PracticeAntoinette Williams
This document discusses the impact of an educational intervention on documentation accuracy at an academic neurosurgery department. The intervention provided training to physicians on properly documenting patient comorbidities. After the intervention, measures of case complexity including severity of illness, risk of mortality, and case mix index all significantly increased, reflecting more accurate documentation. As a result, the average margin per discharge improved by 42.2%, showing the financial impact of improved documentation. The study demonstrates that targeted training can meaningfully improve documentation quality and its effects on quality metrics and revenue.
This document discusses the importance and standards of clinical documentation. It notes that documentation is important for planning treatment, communication between providers, and providing a single source of truth. Good documentation promotes patient safety, cuts down on duplicative work, and provides a record in case of audits or malpractice claims. The document outlines standards like including patient ID, dates, medical history, allergies and notes the legal aspects of documentation like avoiding erasures, being accurate, and maintaining confidentiality. It discusses the benefits of electronic records for storage and access while noting some financial costs. The purpose of documentation is for planning, organization, coordination and control of health services.
Patient safety is the absence of preventable harm to a patient during the process of health care and reduction of risk of unnecessary harm associated with health.
An infection control nurse informed the PICU consultant that two patients have been found to have MDR Acinetobacter infections. This may constitute an Acinetobacter outbreak. The consultant should confirm it is an outbreak by investigating patients and the environment, calculating the attack rate, and comparing it to the background rate. If confirmed, treatment and prevention measures should be implemented, including isolation, cohorting, strict sterilization and disinfection procedures.
A study was conducted among 1256 dental professionals to assess their knowledge and attitudes regarding conservative and endodontic practices during the COVID-19 pandemic. It was found that while the participants had good basic knowledge of COVID-19, areas for improvement were identified. For example, only 43% knew the accurate incubation period. Rubber dams were recognized as useful by 83% but techniques like low-speed handpieces were preferred by only 25%. While PPE kits were seen as important by 72%, only surgical masks were deemed sufficient by 37%. The study concluded that dental professionals need to be cautious when treating patients during the pandemic and limit disease spread.
A study was conducted among 1256 dental professionals to assess their knowledge and attitudes regarding conservative and endodontic practices during the COVID-19 pandemic. It was found that while the participants had good basic knowledge of COVID-19, areas for improvement were identified. For example, only 43% knew the accurate incubation period. Rubber dams were widely recognized as protective tools, but techniques like low-speed handpieces and chemomechanical methods were less familiar. The study concluded that while dental workers understand disease transmission, extra precautions are needed when treating patients during the pandemic.
Informed consent documents are required to explain clinical trials to participants and obtain their signed agreement to participate. They must include the study purpose, procedures, risks/benefits, alternatives to participation, and participant rights. Case report forms are used to record all required study data for each participant and facilitate data collection, management, and analysis while protecting privacy. The investigator's brochure provides investigators details on the investigational product and guidance for the study based on nonclinical and clinical data.
Cyclothymia Test: Diagnosing, Symptoms, Treatment, and Impact | The Lifescien...The Lifesciences Magazine
The cyclothymia test is a pivotal tool in the diagnostic process. It helps clinicians assess the presence and severity of symptoms associated with cyclothymia.
Emotional and Behavioural Problems in Children - Counselling and Family Thera...PsychoTech Services
A proprietary approach developed by bringing together the best of learning theories from Psychology, design principles from the world of visualization, and pedagogical methods from over a decade of training experience, that enables you to: Learn better, faster!
Solution manual for managerial accounting 18th edition by ray garrison eric n...rightmanforbloodline
Solution manual for managerial accounting 18th edition by ray garrison eric noreen and peter brewer_compressed
Solution manual for managerial accounting 18th edition by ray garrison eric noreen and peter brewer_compressed
At Malayali Kerala Spa Ajman we providing the top quality massage services for our customers.
Our massage center prioritizes efficiency to ensure a quality massage experience for our clients at Malayali Kerala Spa Ajman. We offer a convenient appointment system and precise massage services.
Reach us at Villa No 7, Near Ammar Bin Yasir Street Al Rashidiya 2 - Ajman - United Arab Emirates.
Phone : +971 529818279
Dr. Sherman Lai, MD — Guelph's Dedicated Medical ProfessionalSherman Lai Guelph
Guelph native Dr. Sherman Lai, MD, is a committed medical practitioner renowned for his thorough medical knowledge and caring patient care. Dr. Lai guarantees that every patient receives the best possible medical care and assistance that is customized to meet their specific needs. She has years of experience and is dedicated to providing individualized health solutions.
The story of Dr. Ranjit Jagtap's daughters is more than a tale of inherited responsibility; it's a narrative of passion, innovation, and unwavering commitment to a cause greater than oneself. In Poulami and Aditi Jagtap, we see the beautiful continuum of a father's dream and the limitless potential of compassion-driven healthcare.
Health Tech Market Intelligence Prelim Questions -Gokul Rangarajan
The Ultimate Guide to Setting up Market Research in Health Tech part -1
How to effectively start market research in the health tech industry by defining objectives, crafting problem statements, selecting methods, identifying data collection sources, and setting clear timelines. This guide covers all the preliminary steps needed to lay a strong foundation for your research.
This lays foundation of scoping research project what are the
Before embarking on a research project, especially one aimed at scoping and defining parameters like the one described for health tech IT, several crucial considerations should be addressed. Here’s a comprehensive guide covering key aspects to ensure a well-structured and successful research initiative:
1. Define Research Objectives and Scope
Clear Objectives: Define specific goals such as understanding market needs, identifying new opportunities, assessing risks, or refining pricing strategies.
Scope Definition: Clearly outline the boundaries of the research in terms of geographical focus, target demographics (e.g., age, socio-economic status), and industry sectors (e.g., healthcare IT).
3. Review Existing Literature and Resources
Literature Review: Conduct a thorough review of existing research, market reports, and relevant literature to build foundational knowledge.
Gap Analysis: Identify gaps in existing knowledge or areas where further exploration is needed.
4. Select Research Methodology and Tools
Methodological Approach: Choose appropriate research methods such as surveys, interviews, focus groups, or data analytics.
Tools and Resources: Select tools like Google Forms for surveys, analytics platforms (e.g., SimilarWeb, Statista), and expert consultations.
5. Ethical Considerations and Compliance
Ethical Approval: Ensure compliance with ethical guidelines for research involving human subjects.
Data Privacy: Implement measures to protect participant confidentiality and adhere to data protection regulations (e.g., GDPR, HIPAA).
6. Budget and Resource Allocation
Resource Planning: Allocate resources including time, budget, and personnel required for each phase of the research.
Contingency Planning: Anticipate and plan for unforeseen challenges or adjustments to the research plan.
7. Develop Research Instruments
Survey Design: Create well-structured surveys using tools like Google Forms to gather quantitative data.
Interview and Focus Group Guides: Prepare detailed scripts and discussion points for qualitative data collection.
8. Sampling Strategy
Sampling Design: Define the sampling frame, size, and method (e.g., random sampling, stratified sampling) to ensure representation of target demographics.
Participant Recruitment: Plan recruitment strategies to reach and engage the intended participant groups effectively.
9. Data Collection and Analysis Plan
Data Collection: Implement methods for data gathering, ensuring consistency and validity.
Analysis Techniques: Decide on analytical approaches (e.g., statistical
Test bank clinical nursing skills a concept based approach 4e pearson educati...rightmanforbloodline
Test bank clinical nursing skills a concept based approach 4e pearson education
Test bank clinical nursing skills a concept based approach 4e pearson education
Test bank clinical nursing skills a concept based approach 4e pearson education
Ensure the highest quality care for your patients with Cardiac Registry Support's cancer registry services. We support accreditation efforts and quality improvement initiatives, allowing you to benchmark performance and demonstrate adherence to best practices. Confidence starts with data. Partner with Cardiac Registry Support. For more details visit https://cardiacregistrysupport.com/cancer-registry-services/
The facial nerve, also known as cranial nerve VII, is one of the 12 cranial nerves originating from the brain. It's a mixed nerve, meaning it contains both sensory and motor fibres, and it plays a crucial role in controlling various facial muscles, as well as conveying sensory information from the taste buds on the anterior two-thirds of the tongue.
Cancer treatment has advanced significantly over the years, offering patients various options tailored to their specific type of cancer and stage of disease. Understanding the different types of cancer treatments can help patients make informed decisions about their care. In this ppt, we have listed most common forms of cancer treatment available today.
3. decipherable. In addition, the free-text entries contained in
the “potential complications” element of consent forms for
some specific procedures were analysed. The documentation
of a given complication was defined as being “heterogeneous”
if at least 25% of a procedure's consent forms differed in
whether or not they included the complication.
In the second phase of the investigation, we analysed the
potential complications element of standard hand-written
consent form 1s for missing risks and trialled an electronic,
procedure-specific consent platform. This phase was carried
out in a different NHS trust from phase one because of rota-
tion of the primary investigators. Furthermore, data collection
and the trial were restricted to the breast surgery unit to
facilitate detailed, expert-led analysis of the documentation of
potential complications and limit the number of procedures
the investigators would need to establish on the electronic
platform.
The quality of completion of all available hand-written
consent form 1s produced by surgeons from the breast sur-
gery unit during a ten-week period was assessed in the same
manner as described for the first phase. Furthermore, two
independent consultant breast surgeons assessed the docu-
mented risks to determine if essential complications were
missing. The assessors were blinded to other aspects of the
form including the operating surgeon and consenting sur-
geon. Forms were classified as missing complications only on
agreement of both assessors.
We developed an electronic, procedure-specific consent
platform e OpInform.com. The same surgeons in the breast
surgery unit who administered the hand-written consent
forms were given instruction on using the electronic platform
and trialled it during a six-week period. The quality of
completion and content of the electronically-produced con-
sent forms was prospectively assessed during the trial in the
same manner described for hand-written forms.
Results
Phase One e information in hand-written consent forms is
frequently missing or illegible and suffers from wide
variability
In phase one of the investigation we assessed the quality of
completion of hand-written consent forms generated by sur-
gical specialities in one NHS trust across a ten-week period.
Some 99 forms were appraised in total and the proportion of
consent forms from each speciality is detailed in Table 2.
General surgical, orthopaedic and gynaecological procedures
accounted for approximately 75%.
The failure rates for each domain of the consent forms are
given in Table 3. Some 10% of consent forms had incorrect,
illegible or missing responses in the patient details domain. The
failure rate for the procedure details domain was 30%. Of these
failures, 97% were due to illegible handwriting. The failure
rate for patient sign-off was 27% e the vast majority of which
were due to absence of printed name or date, though one form
had not actually been signed by the patient. Overall, only 47
(47%) of the consent forms had no domain failures.
The commonest homogenous procedures for which con-
sent forms were audited were laparoscopic cholecystectomy,
knee arthroscopy and hysterectomy. We analysed the number
of unique complications documented for each procedure.
Table 4 details the descriptive statistics for each procedure in
addition to the proportion of complications whose docu-
mentation was classified as heterogeneous (disagreement
between at least one-in-four forms). Even for these common
operations, there was a large degree of variation in the num-
ber of potential complications documented for a given pro-
cedure. For example, one consent form for laparoscopic
cholecystectomy documented three complications while
another form documented nine. Furthermore, the proportion
of heterogeneous complications was approximately 50% for
each procedure. This suggests that not only is the absolute
number of complications documented variable, there is also
little agreement between forms regarding the specific nature
of these complications.
Phase Two e important complications are frequently
missing from hand-written consent forms which could be
prevented by using electronic, procedure-specific forms
The second phase of the investigation was carried out at a
different NHS trust and was concerned with the prevalence of
failure to document potential complications on hand-written
consent forms. In addition, we piloted an electronic
procedure-specific consent platform. This phase of the
investigation was confined to consent forms produced by the
breast surgery unit to facilitate more detailed analysis of the
consent forms and limit the establishment of procedures on
the electronic platform to one surgical speciality.
Some 61 hand-written consent forms from the breast
surgery unit were assessed over ten weeks and, similarly to
phase one, the quality of completion was suboptimal with
high rates of failure in the patient details and procedure details
domains (Table 5a). Mastectomy (12/61) and wide local
Table 2 e The proportion of consent forms for procedures
from each speciality is given from the 99 assessed in
total.
Speciality Proportion of forms (%)
General 27
Orthopaedic 26
Gynaecology 22
Urology 14
Breast 4
Ear, Nose and Throat 2
Ophthalmology 1
Miscellaneous 3
Table 3 e The domain failure rates for hand-written
consent forms in phase one of the study.
Domain Failure rate (%)
Patient details 10
Procedure details 30
Patient Sign-Off 27
t h e s u r g e o n x x x ( 2 0 1 5 ) 1 e6 3
Please cite this article in press as: St John ER, et al., Completion of hand-written surgical consent forms is frequently suboptimal and
could be improved by using electronically generated, procedure-specific forms, The Surgeon (2015), http://dx.doi.org/10.1016/
j.surge.2015.11.004
4. excision (10/61) were the commonest procedures performed
and both demonstrated significant variability in the number
of potential complications documented with many classified
as heterogeneous (Table 5b). Assessment of the documented
risks of all 61 consent forms by two independent, blinded
consultant breast surgeons revealed that 44% (27/61) consent
forms were missing essential risks. Of these 27 forms, 67%
were missing more than one risk; the commonest being
infection (44%) and lymphoedema (26%).
To improve the quality of consent form completion and
reduce the variability in their contents, we developed a web-
based platform for generating procedure-specific consent
forms e OpInform.com. The platform is designed to produce
consent forms in portable document format (PDF) which
comply with the UK Department of Health's recommenda-
tions. We produced a database of common breast surgery
procedures with benefits and potential complications that
serves as the “back-end” to the platform. The supplementary
material contains screenshots from the platform and an
example consent form. The user selects the appropriate pro-
cedure and inputs the patient details into the electronic form
while suggested operation-specific risks and benefits are pre-
populated from the database. However, these suggestions can
be modified to create a bespoke consent form tailored to the
individual patient. The form is then printed for both the sur-
geon and patient to sign.
We prospectively re-audited the breast surgery unit's con-
sent forms for six weeks following the introduction of OpIn-
form.com and found no domain failures amongst the 29
consent forms produced using the electronic platform. Con-
sent forms for wide local excision were the commonest
audited (seven forms) and there was no variability between
forms in the number or nature of the potential complications
documented.
Discussion
Obtaining informed consent for a surgical procedure is crucial
from both a medico-legal and ethical standpoint. Failure to do
so adequately may expose a surgeon to accusations of negli-
gence or even battery and shows little respect for a patient's
autonomy. The hand-written consent form is currently cen-
tral to the consent process in the majority of institutions,
serving the not entirely aligned roles of medico-legal docu-
mentation and provision of written information to the patient.
It is difficult to estimate the impact of poorly completed con-
sent forms on patient complaints and negligence claims. Such
claims are rarely the result of a single cause and more
commonly arise from a multiplicity of factors, amongst which
issues of consent and inadequate clinical record keeping are
certainly prominent.5e7
A recent retrospective Australian
study by Gogos et al. found that 5% of patient complaints and
malpractice claims involved alleged deficiencies in the con-
sent process.6
In 71% of these cases the primary allegation was
that was that a resulting complication had not been
mentioned or fully understood e a poorly completed, illegible
consent form is unlikely to offer much defence for the
accused. Despite their importance, we have demonstrated
that the completion of hand-written consent forms is
frequently suboptimal and suffers from unacceptable
variability.
In phase one, we prospectively audited 99 consent forms
produced by multiple specialities and found less than half
contained complete, accurate and legible documentation
throughout. In phase two, analysis of a further 61 consent
forms produced by the breast surgery unit at a different UK
Table 4 e Free-text entries for potential complications were analysed for the commonest procedures in each subspecialty
during phase one of the study and descriptive statistics produced. The total number of unique complications documented
amongst all the consent forms for a particular procedure is reported. In addition, the median and range of the number of
documented risks is given. A potential complication for a given procedure was described as “heterogeneous” if at least a
quarter of forms disagreed regarding its inclusion. The number and proportion of heterogeneous complications is reported.
Procedure No. of forms Complications
Total unique Median Range Heterogeneous
Laparoscopic cholecystectomy 7 12 6 2e9 7 (58%)
Arthroscopy 4 6 5 3e5 3 (50%)
Hysterectomy 4 5 3.5 3e5 2 (40%)
Table 5a e The domain failure rate for hand-written
consent forms in phase two of the study.
Domain Failure rate (%)
Patient details 16
Procedure details 38
Patient Sign-Off 0
Table 5b e Free-text entries for potential complications were analysed for the commonest procedures in phase two of the
study.
Procedure No. of forms Complications
Total unique Median Range Heterogeneous
Mastectomy 12 13 5 3e9 8 (62%)
Wide local excision 10 16 9 9e15 4 (25%)
t h e s u r g e o n x x x ( 2 0 1 5 ) 1 e64
Please cite this article in press as: St John ER, et al., Completion of hand-written surgical consent forms is frequently suboptimal and
could be improved by using electronically generated, procedure-specific forms, The Surgeon (2015), http://dx.doi.org/10.1016/
j.surge.2015.11.004
5. trust revealed similar findings. Patient details were missing or
inaccurate in approximately 10% of forms which could have
repercussions as consent forms are often cross-referenced
with the patient identification bracelet during the WHO sur-
gical safety checklist.4
The documentation of the intended
procedure's name, benefits or potential risks was inadequate
in 30e40% of cases, largely due to illegible handwriting. The
assessment of legibility entails a degree of subjectivity but, as
medical trainees, the assessors in the present study could be
expected to have better comprehension than the average
layperson. We also found that the number of complications
documented for a given procedure varied widely, even for
common surgeries, and that the level of disagreement with
regards to the specific nature of these complications was high.
Of more concern, two experts agreed that 44% of the forms
assessed in phase two of the investigation were missing
essential complications. These were not esoteric; they were
common complications such as infection and lymphoedema
(in the context of axillary surgery). Users of the electronic
consent platform had the option to modify the pre-populated
suggested potential complications. However, using wide local
excision as a reference procedure, we found no variability in
the number or nature of complications documented on the
electronically-produced forms. This suggests that the vari-
ability in the documentation of potential complications on
hand-written forms is not due to inherent disagreement be-
tween surgeons regarding the potential complications of a
procedure or individual differences between patients. Rather,
it is a consequence of the ad hoc nature in which hand-written
forms are completed, from memory, often under considerable
timeepressure.
Other studies have investigated the quality of documen-
tation of hand-written consent. Rahman et al. and Thakkar
et al. both found that the legibility of forms for consent to
orthopaedic surgery was generally good but that there was a
high degree of variability regarding the inclusion of potential
complications.8,9
High variability and failure to document key
complications has been further demonstrated in consent for
urological and general surgical procedures and has lead to
calls for standardised, procedure-specific consent forms.10e14
Isherwood et al. improved the documentation of consent
forms for total hip replacements by creating a “complications
sticker” that listed the specific complications for the proce-
dure. In the UK, Barritt et al. developed Orthoconsent, a web-
based platform for the production of consent forms for or-
thopaedic surgery. This platform has been endorsed by the
British Orthopaedic Association and the authors demon-
strated that use of the Orthoconsent forms significantly
improved patients' knowledge of their planned procedure.15
In
the United States, Issa et al. have commercialised a web-
based, multi-speciality, procedure-specific consent system
(iMedConsent™) that is now employed in over 200 hospitals.10
However, the recent change in the UK law on consent stresses
that a surgeon must disclose risks that would probably be
deemed of significance by their specific patient.1,2
With this in
mind, legal commentators have cautioned against taking a
generic, pro forma-based approach to consent because of fear
that this could compromise effective patient dialogue and
prevent forms being individualised.2
However, it must also be
recognised that some type of reminder is helpful to prevent
key risks from being omitted in error. The ability to create a
bespoke form tailored to the individual is therefore crucial in
any consent platform.
OpInform.com is an internet-based platform for the crea-
tion of electronic, procedure-specific consent forms based
upon the UK Department of Health templates. We should
stress that, as an electronic consent platform, OpInform.com
does not attempt to re-invent the fundamentals of the con-
sent process. Rather it simply addresses the demonstrated
deficiencies of hand-written consent forms to the benefit of
both clinicians and patients. However, electronically-
generated consent forms could be produced faster than their
hand-written counterparts which may facilitate the consent-
ing of patients during an outpatient clinic rather than in an ad
hoc manner on the morning of surgery as is common practice.
This would allow patients time to consider the proposed
procedure without duress and consent could then be re-
confirmed on the day of surgery.
OpInform.com has two major advantages over other sys-
tems. Firstly, although suggested risks and benefits are pre-
populated for a specific procedure, these are completely
modifiable. In this way, we introduce the benefits of “semi-
standardisation” based upon the opinion of a body of rele-
vant consultant experts while maintaining the freedom to
tailor the form to the individual patient. Secondly, the system
is designed for pan-speciality use, rather than being
restrained to a particular cohort of procedures. Forms for
procedures that do not yet exist can be quickly added to the
database by using the “suggest an operation” link. Procedures
suggested for inclusion would subsequently be validated
prior to making them available to end-users. In their current
format the forms are printed after completion for the patient
and surgeon to sign, but implementation of a digital signa-
ture is feasible and would make the process truly paperless.16
The application could also be integrated into hospital elec-
tronic health record systems to allow patient details to be
automatically populated and the form to be saved in a pa-
tient's electronic notes.
Conclusion
In summary, we have demonstrated that the completion of
hand-written consent forms is frequently suboptimal and
suffers from wide variation. Against the backdrop of the ever-
increasing use of digital documentation in healthcare it is
perhaps surprising that electronic, procedure-specific consent
forms are not already the standard of care. This may be a
reflection of the lack of a pan-speciality platform that is fully
modifiable by the end-user. We believe that OpInform.com
meets these criteria and can push the consent process into the
digital age.
Conflict of interest
Edward St John conceived and designed OpInform.com while
Alasdair Scott is involved in the design process. Neither
author currently have any financial interests in the project.
t h e s u r g e o n x x x ( 2 0 1 5 ) 1 e6 5
Please cite this article in press as: St John ER, et al., Completion of hand-written surgical consent forms is frequently suboptimal and
could be improved by using electronically generated, procedure-specific forms, The Surgeon (2015), http://dx.doi.org/10.1016/
j.surge.2015.11.004
6. Acknowledgements
Loretta Lau, Clarisa Choh, Alice Thompson & Kirsty Dawson
for their help with data collection.
Appendix A. Supplementary data
Supplementary data related to this article can be found at
http://dx.doi.org/10.1016/j.surge.2015.11.004.
r e f e r e n c e s
1. Montgomery (Appellant) v Lanarkshire Health Board
(Respondent) (Scotland) (2015). UKSC 11.
2. Sokol DK. Update on the UK law on consent. BMJ
2015;350:h1481.
3. Limb M. NHS will be paperless by 2015, says commissioning
board. BMJ 2012;345:e6888.
4. UK Department of Health. Consent form 1: patient agreement to
investigation or treatment. 2009 [accessed 26.05.15], http://
webarchive.nationalarchives.gov.uk/20130107105354/http://
www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/@
dh/@en/documents/digitalasset/dh_4019034.pdf.
5. Goodwin H. Litigation and surgical practice in the UK. Br J Surg
2000;87(8):977e9.
6. Gogos AJ, Clark RB, Bismark MM, Gruen RL, Studdert DM.
When informed consent goes poorly: a descriptive study of
medical negligence claims and patient complaints. Med J Aust
2011;195(6):340e4.
7. Bismark MM, Gogos AJ, McCombe D, Clark RB, Gruen RL,
Studdert DM. Legal disputes over informed consent for
cosmetic procedures: a descriptive study of negligence claims
and complaints in Australia. J Plast Reconstr Aesthet Surg
2012;65(11):1506e12.
8. Thakkar SC, Frassica FJ, Mears SC. Accuracy, legibility, and
content of consent forms for hip fracture repair in a teaching
hospital. J Patient Saf 2010;6(3):153e7.
9. Rahman L, Clamp J, Hutchinson J. Is consent for hip fracture
surgery for older people adequate? The case for pre-printed
consent forms. J Med Ethics 2011;37(3):187e9.
10. Issa MM, Setzer E, Charaf C, Webb AL, Derico R, Kimberl IJ,
et al. Informed versus uninformed consent for prostate
surgery: the value of electronic consents. J Urol
2006;176(2):694e9. discussion 9.
11. Probert N, Malik AA, Lovell ME. Surgery for fractured neck of
femur e are patients adequately consented? Ann R Coll Surg
Engl 2007;89(1):66e9.
12. Isherwood J, Dean B, Pandit H. Documenting informed
consent in elective hip replacement surgery: a simple change
in practice. Br J Hosp Med Lond 2013;74(4):224e7.
13. Loughran D. Surgical consent: the world's largest Chinese
Whisper? A review of current surgical consent practices. J Med
Ethics 2015;41(2):206e10.
14. Chen AM, Leff DR, Simpson J, Chadwick SJ, McDonald PJ.
Variations in consenting practice for laparoscopic
cholecystectomy. Ann R Coll Surg Engl 2006;88(5):482e5.
15. Barritt AW, Clark L, Teoh V, Cohen AM, Gibb PA. Assessing
the adequacy of procedure-specific consent forms in
orthopaedic surgery against current methods of operative
consent. Ann R Coll Surg Engl 2010;92(3):246e9. quiz 2pp.
following 9.
16. Liu H. An electronic management and digital signature
system for surgical consent. J Inf Technol Healthc
2007;5(1):23e33.
t h e s u r g e o n x x x ( 2 0 1 5 ) 1 e66
Please cite this article in press as: St John ER, et al., Completion of hand-written surgical consent forms is frequently suboptimal and
could be improved by using electronically generated, procedure-specific forms, The Surgeon (2015), http://dx.doi.org/10.1016/
j.surge.2015.11.004