The regulation of the unscheduled care takes part of the different methods engaged to better organize the global demand for unscheduled urgent care among the different levels of care. Indeed, the first level of care equally with the emergency departments are facing major patient inflows often exceeding their available resources. Technological advances in healthcare and spreading of medical information reveal themselves as precursors of new adaptive strategies and daily challenges. The creation of an interactive app for patients self-triage through the different levels of care involves those different concepts. We created a new interactive platform, the ODISSEE mobile application (Outil Décisionnel et Informatif des Structures de Soins Efficientes Existantes), to allow patient's self-triage to the best level of care. The protocols used were directly based on a previously validated tool with a 5-year experience in our institution, the SALOMON algorithm (Système Algorithmique Liégeois d'Orientation pour la Médecine Omnipraticienne Nocturne). Establishment of interactive self-triage platform to guide patients to the best level of care could potentially be a promising tool to improve the regulation of unscheduled urgent care.
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BMC Med Inform Decis Mak
December 2024
New Cross Hospital, The Royal Wolverhampton NHS Trust, Wolverhampton, WV10 0Q, UK.
Background: Numerous tools based on electronic health record (EHR) data that predict risk of unscheduled care and mortality exist. These are often criticised due to lack of external validation, potential for low predictive ability and the use of thresholds that can lead to large numbers being escalated for assessment that would not have an adverse outcome leading to unsuccessful active case management. Evidence supports the importance of clinical judgement in risk prediction particularly when ruling out disease.
View Article and Find Full Text PDFJ Cancer Surviv
November 2024
Department of Psychiatry, Michigan State University College of Osteopathic Medicine, East Lansing, MI, USA.
Purpose: Three sequences of telephone symptom management interventions were tested on use of unscheduled health services among cancer survivors with depressive or anxiety symptoms during treatment (N = 334) and their informal caregivers (N = 333).
Methods: The three 12-week intervention sequences were as follows: (1) Symptom Management and Survivorship Handbook (SMSH), (2) a combined 8-week SMSH + Telephone Interpersonal Counseling (TIPC) followed by SMSH for 4 weeks, and (3) SMSH for 4 weeks followed by a combined SMSH + TIPC if no response to SMSH alone. Survivor-caregiver dyads were first randomized to SMSH or a combined SMSH + TIPC.
J Med Internet Res
November 2024
Craig Cardiovascular Center, San Antonio, TX, United States.
Background: Rural populations have a disproportionate burden of heart failure (HF) morbidity and mortality, associated with socioeconomic and racial inequities. Multiple randomized controlled trials of remote patient monitoring (RPM) using both direct patient contact and device-based monitoring have been conducted to assess improvement in HF outcomes, with mixed results.
Objective: We aimed to assess whether a novel digital health care platform designed to proactively assess and manage patients with HF improved patient outcomes by preventing HF re-exacerbations, thus reducing emergency room visits and HF hospitalizations.
J Adv Nurs
November 2024
Division of Emergency Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.
Emerg Nurse
September 2024
School of Medicine, Dentistry and Nursing, University of Glasgow, Glasgow, Scotland and NHS Greater Glasgow and Clyde, Glasgow, Scotland.
Telemedicine is increasingly used in healthcare settings, including in unscheduled care. This article details the findings of a literature review that aimed to determine the benefits and limitations of using telemedicine in unscheduled care. The findings suggest that the use of telemedicine can be cost-effective for patients and healthcare providers and may reduce hospital transfer and admission rates.
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