Quality and Safety in the Literature: May 2022

Albert G. Emery, N. Houchens, Ashwin Gupta
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Abstract

© Author(s) (or their employer(s)) 2022. No commercial reuse. See rights and permissions. Published by BMJ. COMPARATIVE EFFECTIVENESS OF AN AUTOMATED TEXT MESSAGING SERVICE FOR MONITORING COVID-19 AT HOME Ann Intern Med, 16 November 2021 As cases of SARSCoV2 infection (COVID19) have risen dramatically over the course of the pandemic, global interest in utilisation of telemedicine services has increased. 2 In an effort to avoid exposure to infected persons in healthcare settings, the total number of virtual health encounters has risen sharply in both primary care and subspecialty clinics. 4 Even prior to the onset of the pandemic, telemedicine services were used in a myriad of specialties, ranging from cardiothoracic surgery to psychiatry to palliative care as a means of monitoring symptoms and collecting patient data to detect and address early patient deterioration and prevent excess morbidity and mortality. Early in the pandemic, clinicians and researchers quickly noted the opportunities for telemedicine to prevent such morbidity and mortality specifically related to COVID19. 9 An application called COVID Watch, developed by researchers at the University of Pennsylvania Health System (Penn Medicine), is a home monitoring programme for outpatients diagnosed with COVID19. COVID Watch sends twicedaily automated text messages to patients, inquiring about worsening symptoms and increased shortness of breath. In the event of worsening shortness of breath, the patient is contacted by a clinician via telephone within 1 hour for further evaluation and consideration of emergency department (ED) escalation. To understand the effectiveness of the COVID Watch programme, Delgado and colleagues performed a retrospective cohort study, analysing a population of patients within Penn Medicine. Included patients were adults aged 18 years or older who tested positive for COVID19 in the outpatient setting between 23 March and 30 November 2020. Excluded were people enrolled in home health or hospice services, those residing at longterm care facilities, those with active ‘do not resuscitate’ orders and those tested for COVID19 in areas where COVID Healthcare quality and safety span multiple topics across the spectrum of academic and clinical disciplines. Keeping abreast of the rapidly growing body of work can be challenging. In this series, we provide succinct summaries of selected relevant studies published in the last several months. Some articles will focus on a particular theme, whereas others will highlight unique publications from highimpact medical journals.
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文献中的质量与安全:2022年5月
©作者(或其雇主)2022。无商业再利用。请参阅权限和权限。BMJ出版。2021年11月16日,在HOME Ann Intern Med监测新冠肺炎的自动短信服务的比较效果随着SARSCoV2感染(COVID19)病例在大流行期间急剧上升,全球对远程医疗服务利用的兴趣也在增加。2为了避免在医疗环境中接触到感染者,初级保健和专科诊所的虚拟健康接触总数都急剧增加。4甚至在疫情爆发之前,远程医疗服务就被用于许多专业,从心胸外科到精神病学再到姑息治疗,作为监测症状和收集患者数据的一种手段,以检测和解决早期患者恶化问题,防止过度发病率和死亡率。在疫情早期,临床医生和研究人员很快注意到远程医疗有机会预防这种与新冠肺炎特别相关的发病率和死亡率19。9宾夕法尼亚大学卫生系统(宾夕法尼亚医学院)的研究人员开发了一款名为“新冠肺炎观察”的应用程序,它是一项针对确诊为新冠肺炎的门诊患者的家庭监测计划19。COVID Watch每两次自动向患者发送短信,询问症状恶化和呼吸急促加剧的情况。如果呼吸急促恶化,临床医生会在1小时内通过电话联系患者,以进行进一步评估并考虑急诊科(ED)的升级。为了了解新冠肺炎观察计划的有效性,Delgado及其同事进行了一项回顾性队列研究,分析了宾夕法尼亚医学院的患者群体。纳入的患者是2020年3月23日至11月30日期间在门诊环境中新冠肺炎检测呈阳性的18岁或以上的成年人19。排除在外的有参加家庭健康或临终关怀服务的人、居住在长期护理机构的人、有积极“不复苏”命令的人,以及在新冠肺炎医疗质量和安全涉及学术和临床学科多个主题的地区接受新冠肺炎检测的人19。跟上快速增长的工作量可能具有挑战性。在本系列中,我们简要总结了过去几个月发表的一些相关研究。一些文章将聚焦于一个特定的主题,而另一些文章则强调来自高影响力医学期刊的独特出版物。
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Quality & Safety in Health Care
Quality & Safety in Health Care 医学-卫生保健
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Accuracy of telephone triage for predicting adverse outcomes in suspected COVID-19: an observational cohort study. Quality framework for remote antenatal care: qualitative study with women, healthcare professionals and system-level stakeholders. Addressing social determinants of health in primary care: a quasi-experimental study using unannounced standardised patients to evaluate the impact of audit/feedback on physicians' rates of identifying and responding to social needs. Reporting on implementation trials with null findings: the need for concurrent process evaluation reporting. Antibiotic documentation: death by a thousand clicks.
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