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Mashup Score: 0Embedding genomics across the NHS: a primary care perspective - 5 month(s) ago
Primary care remains the point of access to the NHS as well as having key roles in care coordination and prescribing. Therefore, embedding of genomic medicine in the NHS relies on successful implementation into the primary care landscape. Primary care is currently facing considerable challenges, including increasing numbers of patients and consultations per GP, multiple health conditions and polypharmacy, all contributing to increasing workload within a resource-constrained system. Although genomic medicine has enormous potential to benefit patients, its successful implementation demands alignment with existing skills and working practices, development of underpinning informatics infrastructure, integration into care pathways with consideration of commissioning and leadership. Here, we set out current initiatives and future strategies to support primary care colleagues in the delivery of genomic medicine, covering issues of workforce development and education, primary care leadership,
Source: www.rcpjournals.orgCategories: General Medicine News, Hem/OncsTweet
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Mashup Score: 10Duration of consultant experience and patient outcome following acute medical unit admission: an observational cohort study - 7 month(s) ago
Background The effect of the duration of consultant experience on clinical outcomes in the acute medical unit (AMU) model remains unknown. Methods Unscheduled AMU admissions (n=66,929) admitted by 56 consultant physicians between 2017 and 2020 to two large teaching hospital AMUs in Lothian, Scotland were examined. The associations of consultant experience on AMU with patient discharge, mortality, readmission and postdischarge death were calculated adjusting for clinical acuity, pathology and comorbidity. Results Increasing consultant experience was associated with a continuous increase in likelihood of early AMU discharge (odds ratio (OR) 1.08; 95% confidence interval (CI) 1.07–1.10; p<0.001 per 5 years' experience), which persisted after adjustment for confounders (OR 1.06; 95% CI: 1.01–1.11; p=0.01). There was no association with early readmission, death after discharge or 30-day inpatient mortality. The marginal effect estimate translates into 31 (95% CI: 25–36), 41 (95% CI: 30–53)
Source: www.rcpjournals.orgCategories: General Medicine News, Cardiologists1Tweet-
RT @marcus_lyall: https://t.co/q0ZlfCfsT3 New data analysing the importance of consultant retention in medicine. Bottom line = sustainable…
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Mashup Score: 1
Deaths in hospital represent a vital learning opportunity for both individual clinicians and the wider healthcare system. Many deaths are reviewed and discussed in morbidity and mortality meetings, with the Royal College of Physicians promoting Structured Judgement Review (SJR) methodology to support this discussion. An analysis of 1 year of SJRs in one hospital was undertaken, generating a toolkit to support junior doctors in evaluating in-hospital deaths. Here, the opportunities and limitations of this analysis are discussed, with consideration of ways to improve the uptake of SJR across the hospital team. These reviews exemplify one way of maximising learning from in-hospital deaths.
Source: www.rcpjournals.orgCategories: Cardiologists, Latest HeadlinesTweet-
RT @drol007: Also live on google scholar 👨🏼🏫 now slight delay on the line https://t.co/wHczEcOfto
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Mashup Score: 10Duration of consultant experience and patient outcome following acute medical unit admission: an observational cohort study - 7 month(s) ago
Background The effect of the duration of consultant experience on clinical outcomes in the acute medical unit (AMU) model remains unknown. Methods Unscheduled AMU admissions (n=66,929) admitted by 56 consultant physicians between 2017 and 2020 to two large teaching hospital AMUs in Lothian, Scotland were examined. The associations of consultant experience on AMU with patient discharge, mortality, readmission and postdischarge death were calculated adjusting for clinical acuity, pathology and comorbidity. Results Increasing consultant experience was associated with a continuous increase in likelihood of early AMU discharge (odds ratio (OR) 1.08; 95% confidence interval (CI) 1.07–1.10; p<0.001 per 5 years' experience), which persisted after adjustment for confounders (OR 1.06; 95% CI: 1.01–1.11; p=0.01). There was no association with early readmission, death after discharge or 30-day inpatient mortality. The marginal effect estimate translates into 31 (95% CI: 25–36), 41 (95% CI: 30–53)
Source: www.rcpjournals.orgCategories: Cardiologists1, Latest HeadlinesTweet-
RT @marcus_lyall: https://t.co/q0ZlfCfsT3 New data analysing the importance of consultant retention in medicine. Bottom line = sustainable…
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Mashup Score: 1Care of the dying person before and during the COVID-19 pandemic: A quality improvement project - 8 month(s) ago
The current COVID-19 pandemic has necessitated the redeployment of NHS staff to acute-facing specialties, meaning that care of dying people is being provided by those who may not have much experience in this area. This report details how a plan, do, study, act (PDSA) approach was taken to implementing improved, standardised multidisciplinary documentation of individualised care and review for people who are in the last hours or days of life, both before and during the COVID-19 pandemic. The documentation and training produced is subject to ongoing review via the specialist palliative care team’s continuously updated hospital deaths dashboard, which evaluates the care of patients who have died in the trust. We hope that sharing the experiences and outcomes of this process will help other trusts to develop their own pathways and improve the care of dying people through this difficult time and beyond.
Source: www.rcpjournals.orgCategories: Healthcare Professionals, Latest HeadlinesTweet-
RT @drol007: @pash22 Feel remiss if we don’t link to our @FutureHealthJ work @Clin_Med https://t.co/Ht0Utiflxe @SimonTavabie all about our…
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Mashup Score: 2
Deaths in hospital represent a vital learning opportunity for both individual clinicians and the wider healthcare system. Many deaths are reviewed and discussed in morbidity and mortality meetings, with the Royal College of Physicians promoting Structured Judgement Review (SJR) methodology to support this discussion. An analysis of 1 year of SJRs in one hospital was undertaken, generating a toolkit to support junior doctors in evaluating in-hospital deaths. Here, the opportunities and limitations of this analysis are discussed, with consideration of ways to improve the uptake of SJR across the hospital team. These reviews exemplify one way of maximising learning from in-hospital deaths.
Source: www.rcpjournals.orgCategories: Healthcare Professionals, Latest HeadlinesTweet-
What can you learn as a foundation doctor from analysing deaths in hospital? https://t.co/qUjmqmvhOc via @drol007 et al
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Mashup Score: 2
Deaths in hospital represent a vital learning opportunity for both individual clinicians and the wider healthcare system. Many deaths are reviewed and discussed in morbidity and mortality meetings, with the Royal College of Physicians promoting Structured Judgement Review (SJR) methodology to support this discussion. An analysis of 1 year of SJRs in one hospital was undertaken, generating a toolkit to support junior doctors in evaluating in-hospital deaths. Here, the opportunities and limitations of this analysis are discussed, with consideration of ways to improve the uptake of SJR across the hospital team. These reviews exemplify one way of maximising learning from in-hospital deaths.
Source: www.rcpjournals.orgCategories: Latest Headlines, Oncologists2Tweet-
RT @drol007: @zachary_tait it’s live and in beautiful pdf https://t.co/wHczEcOfto @Clin_Med @lumpyeggbass #SJR #mortality #palliativecare
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Mashup Score: 0Psychological considerations for the holistic management of obesity - 8 month(s) ago
Psychological presence in multidisciplinary obesity teams has been highlighted as an important component of such teams. Although mentioned in guidelines and recommendations, there is little information regarding the extent to which this is present currently in weight management services, and in what form. Here, we discuss important ways in which psychological aspects of obesity can impact a person living with obesity and how psychology can be incorporated to provide holistic support in weight management services. Recommendations are also made to create clearer guidelines to provide a more robust reference for the inclusion of psychology in multidisciplinary teams.
Source: www.rcpjournals.orgCategories: Hem/Oncs, Latest HeadlinesTweet-
Psychological considerations for the holistic management of obesity https://t.co/khM4Lp6rMH via @Clin_Med https://t.co/GtwiYcLpnQ
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Mashup Score: 0Managing depression in frail older people; too little too late or pathologising loss? - 9 month(s) ago
It is testament to the advances of modern medicine that we have a population with more older people than ever before. While we are increasingly adept at managing their physical comorbidities, we have made relatively little progress in addressing the psychological impact of ageing. In this article we consider the prevalence and complex aetiology of depression in older people who often have to deal with profound loss, while simultaneously managing multiple comorbidities. We consider the challenges of diagnosing depression faced by healthcare professionals including access to resources and training, and what differentiates depression from socially appropriate low mood. Finally, we discuss treatment options and the difficulties that clinicians face when they have only limited resources and skills available, but a desire to help. We consider the role for antidepressants, and when not to prescribe, before addressing the challenges of providing talking therapies and social interventions.
Source: www.rcpjournals.orgCategories: Hem/Oncs, Latest HeadlinesTweet-
Managing depression in frail older people; too little too late or pathologising loss? https://t.co/x9GnJaV5I5 via @sean9n et al
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Embedding genomics across @NHSEngland : a primary care perspective https://t.co/nmHwvRRF4L via @DrImranRafi et al