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  1. Article ; Online: Managing Patients in the COVID-19 Pandemic: A Virtual Multidisciplinary Approach.

    Ganesh, Ravindra / Salonen, Bradley R / Bhuiyan, M Nadir / Bierle, Dennis M / Moehnke, Darcie / Haddad, Tufia C / Tande, Aaron J / Wilson, John / Hurt, Ryan T

    Mayo Clinic proceedings. Innovations, quality & outcomes

    2020  Volume 5, Issue 1, Page(s) 118–126

    Abstract: ... COVID-19)-positive nasopharyngeal polymerase chain reaction tests.: Patients and methods: The current ... Conclusion: Our innovative multidisciplinary COVID team provided excellent clinical care for patients ... study was approved by the Mayo Clinic COVID-19 Research Committee and the Mayo Clinic ...

    Abstract Objective: To study the impact of a 60-day pilot of an innovative virtual-care model using general internal medicine physicians and nurses to respond rapidly to more than 1200 coronavirus disease-2019 (COVID-19)-positive nasopharyngeal polymerase chain reaction tests.
    Patients and methods: The current study was approved by the Mayo Clinic COVID-19 Research Committee and the Mayo Clinic Institutional Review Board. The data for all SARS-CoV-2-positive patients treated by our team were entered into a prospectively maintained internal research electronic data capture database. We searched this database retrospectively for the first 60 days of our program (March 23, 2020 to May 22, 2020). The data included basic deidentified demographics; symptoms at intake into the program; date of symptom onset; risk factors; location; and outcomes including hospitalization, admission to intensive care unit, and death.
    Results: Patients were contacted, on average, 6.3 hours after their results became available. There was a total of 138 ED visits. Of these, 40% were admitted to the hospital, with 36% of those admitted requiring intensive care unit level of care. Of the 849 patients in this sample, there were only 2 deaths (0.23%) at 60 days.
    Conclusion: Our innovative multidisciplinary COVID team provided excellent clinical care for patients with COVID, with a very low mortality rate compared with the national average. Although data are not available on a national scale for time to contact patient, our team was able to contact patients within the established recommendation for contact within 48 hours of testing, which is optimal.
    Language English
    Publishing date 2020-12-15
    Publishing country Netherlands
    Document type Journal Article
    ISSN 2542-4548
    ISSN (online) 2542-4548
    DOI 10.1016/j.mayocpiqo.2020.12.003
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Team Approach: Virtual Care in the Management of Orthopaedic Patients.

    Rubinger, Luc / Gazendam, Aaron / Wood, Thomas / Yardley, Darryl / Shanthanna, Harsha / Bhandari, Mohit

    JBJS reviews

    2021  Volume 9, Issue 7

    Abstract: ... with the recent COVID-19 pandemic.: »: Remote, technology-based patient care is not a "one-size-fits ... multidisciplinary team-based approaches and systems of care on patient outcomes, health-care expenditure, and ... sectors in health care. The utilization and implementation of virtual-care technologies have further been accelerated ...

    Abstract »: Telemedicine and remote care administered through technology are among the fastest growing sectors in health care. The utilization and implementation of virtual-care technologies have further been accelerated with the recent COVID-19 pandemic.
    »: Remote, technology-based patient care is not a "one-size-fits-all" solution for all medical and surgical conditions, as each condition presents unique hurdles, and no true consensus exists regarding the efficacy of telemedicine across surgical fields.
    »: When implementing virtual care in orthopaedics, as with standard in-person care, it is important to have a well-defined team structure with a deliberate team selection process. As always, a team with a shared vision for the care they provide as well as a supportive and incentivized environment are integral for the success of the virtual-care mechanism.
    »: Future studies should assess the impact of primarily virtual, integrated, and multidisciplinary team-based approaches and systems of care on patient outcomes, health-care expenditure, and patient satisfaction in the orthopaedic population.
    MeSH term(s) COVID-19 ; Humans ; Musculoskeletal Diseases/diagnosis ; Musculoskeletal Diseases/therapy ; Patient Care Team ; Telemedicine
    Language English
    Publishing date 2021-07-16
    Publishing country United States
    Document type Journal Article ; Review
    ISSN 2329-9185
    ISSN (online) 2329-9185
    DOI e20.00299
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  3. Article: An updated audit of the patient selection process for pain management programmes in a speciality care service before and during the COVID-19 pandemic.

    Buscemi, Valentina / Chicken, Joe / Mahy, Tim / Knight, Lucie / Scott, Whitney

    British journal of pain

    2022  Volume 17, Issue 3, Page(s) 226–238

    Abstract: ... to the COVID-19 pandemic with virtual delivery implemented in many services. Little is known ... pain management pathway, most patients were offered a PMP option within the service before and during the pandemic ... the pandemic. Psychosocial complexities and unwillingness to engage in a pain management approach that does not ...

    Abstract Background: The provision of pain management programmes (PMPs) changed substantially in response to the COVID-19 pandemic with virtual delivery implemented in many services. Little is known about patient selection processes for virtual PMPs and how this might differ from in-person programmes. The aim of this audit was to document the patient selection process for PMPs at a speciality pain service prior to and during the pandemic.
    Methods: This retrospective audit used data from consecutive patients attending a multidisciplinary assessment to determine the suitability of a PMP. Anonymized data were extracted from assessment letters and hospital records in the months prior to the pandemic (n =168) and during the start of the pandemic once the service began delivering virtual PMPs (n =171).
    Results: For the standard pain management pathway, most patients were offered a PMP option within the service before and during the pandemic, although a greater proportion of patients were offered treatment during the pandemic. For the neuromodulation pathway, most patients were offered a pre-neuromodulation PMP option, and this was similar before and during the pandemic. Psychosocial complexities and unwillingness to engage in a pain management approach that does not principally focus on pain reduction were the most common reasons that patients were not offered a programme.
    Discussion: This audit points to a pattern of more inclusive assessment outcomes within our service over time and particularly during the pandemic. Offering a range of in-person and virtual PMPs can meet a wider range of patient need. Research is needed to understand how to best assess and match patients with the breadth of treatment delivery formats now available.
    Language English
    Publishing date 2022-12-23
    Publishing country England
    Document type Journal Article
    ZDB-ID 2670872-3
    ISSN 2049-4645 ; 2049-4637
    ISSN (online) 2049-4645
    ISSN 2049-4637
    DOI 10.1177/20494637221147200
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  4. Article: The Role of Telemedicine in Enhancing Chronic Kidney Disease (CKD) Management and Dialysis Care.

    Santosh, Ramchandani / Mohammed, Yaqub Nadeem / Rahaman, Zubair / Khurana, Sakshi

    Cureus

    2024  Volume 16, Issue 3, Page(s) e55816

    Abstract: ... a multidisciplinary approach to care, allowing for timely intervention and follow-ups, which are crucial for patients ... undergoing dialysis. Moreover, the COVID-19 pandemic has accelerated the adoption of telemedicine, showcasing ... promise in enhancing the care and management of CKD and dialysis patients. It offers a vital solution ...

    Abstract Telemedicine has emerged as a transformative solution in the realm of healthcare, particularly in addressing the complexities and challenges associated with chronic kidney disease (CKD) and dialysis care. This editorial explores the potential of telemedicine in revolutionizing the management and treatment of kidney diseases, highlighting its role in mitigating the burdens faced by healthcare systems worldwide. With the advent of high-quality audio and visual platforms, telemedicine has facilitated remote healthcare delivery, enabling healthcare professionals to provide exceptional care from a distance. This is particularly relevant in the context of CKD and end-stage kidney disease (ESKD) patients, where the need for continuous care and monitoring is critical. This editorial underscored the escalating incidence of ESKD, driven by prevalent risk factors, such as diabetes, hypertension, and obesity, and the disparities in access to treatments among different populations. The integration of telemedicine in CKD and dialysis care presents a pathway toward a more accessible, efficient, and cost-effective healthcare delivery. It offers numerous benefits, including the convenience of remote monitoring, enhanced patient compliance, reduced healthcare costs, and improved patient satisfaction and quality of life. Telemedicine facilitates a multidisciplinary approach to care, allowing for timely intervention and follow-ups, which are crucial for patients undergoing dialysis. Moreover, the COVID-19 pandemic has accelerated the adoption of telemedicine, showcasing its effectiveness in maintaining continuity of care amid restrictions on patient contact. Despite its promising potential, its implementation of telemedicine faces several challenges, including regulatory hurdles, concerns about the security of medical information, and the adequacy of virtual platforms to capture crucial health indicators. In addition, the financial implications of telemedicine and its long-term sustainability remain areas requiring further investigation. In conclusion, telemedicine holds significant promise in enhancing the care and management of CKD and dialysis patients. It offers a vital solution to overcome the geographical barrier, improve access to care, and alleviate the strain on healthcare systems. However, further research is needed to fully understand its benefits compared to traditional care models and to address the challenges associated with implementation. The expansion of telemedicine in kidney care signifies a step toward a more inclusive, efficient, and patient-centered healthcare future.
    Language English
    Publishing date 2024-03-08
    Publishing country United States
    Document type Editorial
    ZDB-ID 2747273-5
    ISSN 2168-8184
    ISSN 2168-8184
    DOI 10.7759/cureus.55816
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  5. Article ; Online: Remarks on the management of proximal femoral fractures in times of COVID-19 pandemic.

    Basile, G

    La Clinica terapeutica

    2022  Volume 173, Issue 5, Page(s) 398–399

    Abstract: ... approach for PFF patients, who must be treated surgically as soon as possible in order to limit the risk ... rates especially in fragile patients. It is essential to operate through a timely multidisciplinary ... longer hospitalization and higher healthcare costs. The COVID-19 pandemic has severely impacted ...

    Abstract Abstract: Proximal femoral fractures (PFFs) are among the main causes of hospitalization of elderly patients. They are often challenging to manage at the perioperative stage, which is why appropriate monitoring is recommended in order to prevent and - whenever possible - avoid tforeseeable complications (infections, bedsores, bronchopneumonia, psychicological deterioration and worsening general conditions), reduce the mortality rate, facilitate functional recovery and restore the patient's ability to walk and return to everyday life activities and a normal family context. PFFs constitute a major adverse event for elderly patients, often over the age of eighty and with possible issues arising from a substantially unstable and deficient biological balance, with negative repercussions on their quality of life, longer hospitalization and higher healthcare costs. The COVID-19 pandemic has severely impacted the healthcare systems of virtually all world countries, giving rise to serious operational management difficulties (e.g. surgical staff shortages, less availability of surgical facilities, reassignment of surgical staff to other tasks, the need to convert facilities into intensive care units and dedicated COVID + operating rooms, reconfiguration of pathways and procedures with longer anesthesiological and surgical preparation times, environmental sanitation, etc.). All such factors have prolonged waiting times for surgery, causing higher complications rates especially in fragile patients. It is essential to operate through a timely multidisciplinary approach for PFF patients, who must be treated surgically as soon as possible in order to limit the risk of secondary complications due to prolonged bed rest and facilitate a rapid functional recovery.
    MeSH term(s) Aged ; COVID-19 ; Femoral Fractures/surgery ; Hospitalization ; Humans ; Pandemics/prevention & control ; Quality of Life
    Language English
    Publishing date 2022-09-26
    Publishing country Italy
    Document type Letter
    ZDB-ID 123320-8
    ISSN 1972-6007 ; 0009-9074
    ISSN (online) 1972-6007
    ISSN 0009-9074
    DOI 10.7417/CT.2022.2453
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  6. Article: Behavioral Activation (BA) in the Management of Depression in an Adolescent with Down Syndrome in Dubai.

    Shadan, Sidra / Almarzooqi, Sarah / Sultan, Meshal A

    Case reports in psychiatry

    2021  Volume 2021, Page(s) 7112034

    Abstract: ... approach was utilized in developing a personalized management plan for the patient since the initial ... due to circumstances associated with physical distancing with the COVID-19 pandemic. Parents were ... of her clinical depression. In this report, we discuss BA further as a potentially effective therapeutic approach ...

    Abstract Depression has been commonly treated with psychotherapy and/or pharmacotherapy for several decades. Ongoing research in the field has suggested promise for behavioral activation (BA), a form of psychotherapeutic intervention, as a means of increasing engagement in adaptive activities and developing skills to counter avoidance in individuals suffering from depression. In this case report, we present the treatment course of BA for an adolescent with Down syndrome (DS), presenting with depression. A multidisciplinary approach was utilized in developing a personalized management plan for the patient since the initial presentation. Sessions at the outpatient psychiatry clinic alternated between in-person visits and virtual ones, due to circumstances associated with physical distancing with the COVID-19 pandemic. Parents were included as integral parts of the management plan, and education, strategic implementation of BA, and barriers to care were discussed extensively to support the adolescent through the course of her treatment. Within 6 weeks of introducing BA, positive outcomes were noted in the patient, with the resolution of her clinical depression. In this report, we discuss BA further as a potentially effective therapeutic approach to the treatment of depressive symptoms in children and adolescents with DS and intellectual disabilities.
    Language English
    Publishing date 2021-09-18
    Publishing country United States
    Document type Case Reports
    ZDB-ID 2629914-8
    ISSN 2090-6838 ; 2090-682X
    ISSN (online) 2090-6838
    ISSN 2090-682X
    DOI 10.1155/2021/7112034
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  7. Article ; Online: Fifteen-minute consultation: An approach to the management of PIMS-TS in a district general hospital.

    Freitas, Joana / Sanpera, Julia / Dessouki, Tareq / Rainsley, Victoria / Nyirenda, Maggie / Canet Tarrés, Anna / Thomas, Jessica

    Archives of disease in childhood. Education and practice edition

    2021  Volume 107, Issue 6, Page(s) 408–414

    Abstract: ... of the condition has developed, more patients are now managed in a DGH, with virtual multidisciplinary team ... The COVID-19 pandemic has caused significant disease across the globe but children seem to be much ... involvement. This paper outlines a structured approach to management of children presenting with suspected ...

    Abstract The COVID-19 pandemic has caused significant disease across the globe but children seem to be much less affected than adults. Coincidentally with the first wave of the pandemic, a cluster of children with fever, hyperinflammation and shock were identified, and this was first described as paediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2 (PIMS-TS) by the Royal College of Paediatrics and Child Health. Patients with this novel condition were transferred to tertiary centres for management, increasing the pressure in these hospitals that were already extremely busy. There are multiple challenges related to the identification of patients presenting with PIMS-TS given that they mimic multiple other well-known paediatric conditions, like Kawasaki disease and toxic shock syndrome. Investigations and admission criteria to a district general hospital (DGH) need to be well established, and clear guidance should be available for easy decision making in a busy paediatric emergency department. Furthermore, these children can deteriorate suddenly and rapidly; close monitoring is vital, and any deterioration must be taken seriously and addressed immediately. All children who present severely ill, with shock and multiorgan failure, should be retrieved to a paediatric intensive care unit. As our knowledge of the condition has developed, more patients are now managed in a DGH, with virtual multidisciplinary team involvement. This paper outlines a structured approach to management of children presenting with suspected PIMS-TS in a DGH.
    MeSH term(s) Child ; Humans ; COVID-19 ; Pandemics ; SARS-CoV-2 ; Hospitals, General ; Referral and Consultation
    Language English
    Publishing date 2021-10-25
    Publishing country England
    Document type Journal Article
    ZDB-ID 2148818-6
    ISSN 1743-0593 ; 1743-0585
    ISSN (online) 1743-0593
    ISSN 1743-0585
    DOI 10.1136/archdischild-2021-321921
    Database MEDical Literature Analysis and Retrieval System OnLINE

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