Abstract:
RATIONALE, AIMS, AND OBJECTIVES:National policy, guided by research, suggests several patient and service benefits achieved by providing 7-day health care. Therefore, a 7-day inpatient neurophysiotherapy service was introduced at a large teaching hospital in London. The study's aim was to evaluate the effect of the 7-day service on physiotherapy provision, length of stay (LOS), and patient experience. METHOD:Baseline data from the 5-day service were collected for 6 months. Data included time to first neurophysiotherapy assessment, average number of sessions per week, total number of physiotherapy minutes provided, physiotherapy LOS, and hospital LOS. Once 7-day working (7DW) commenced, involving daily physiotherapy for all patients applicable for physiotherapy, data were collected for 6 months and compared with the 5-day service. Patient and carer feedback were also obtained through structured interviews from a sample of patients and their carers. RESULTS:Data from 286 patients (148 patients pre and 138 patients post 7DW) were analysed. Post 7DW, the percentage of patients seen by a physiotherapist within 24 hours increased from 69.9% to 94.9%. Patients also received more physiotherapy sessions per week during their hospital LOS. For demographically similar patients, physiotherapy LOS (24.8-17.4 d, P = .02) and total hospital LOS (32-23.4 d, P = .04) significantly reduced. Twenty-four structured interviews were completed (17 patients and seven carers). Carers preferred a 7-day physiotherapy service as it was perceived to provide more physiotherapy for patients. However, patients valued the consistency of seeing the same therapist during the 5-day service, as this was perceived to develop therapeutic relationships and result in faster treatment progression. CONCLUSIONS:This study has demonstrated that 7DW can improve timely access to more intensive physiotherapy whilst reducing LOS for demographically similar patients. Whilst patients and carers liked having daily physiotherapy, consideration is required to ensure consistency of therapists treating patients.
journal_name
J Eval Clin Practjournal_title
Journal of evaluation in clinical practiceauthors
McGlinchey MP,Buttery Cdoi
10.1111/jep.13237subject
Has Abstractpub_date
2020-06-01 00:00:00pages
777-785issue
3eissn
1356-1294issn
1365-2753journal_volume
26pub_type
杂志文章abstract:RATIONALE:Recent reports indicate that approximately 10% of in-patients in UK hospitals are involved in an adverse event (these reports also state that 50% of these events are preventable). This is indeed a worrying finding, and indicates the need to look at how these incidents are handled or indeed, what is done to mi...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/j.1365-2753.2011.01759.x
更新日期:2012-12-01 00:00:00
abstract:RATIONALE, AIMS AND OBJECTIVES:Cambodia is one of the 22 countries with a high burden of tuberculosis (TB). People often first seek treatment for cough and other TB symptoms through private pharmacies. The National Tuberculosis Programme trained willing private sector pharmacies to refer TB symptomatic clients to their...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/jep.12306
更新日期:2015-04-01 00:00:00
abstract::The paper evaluates the importance of conceptions underlying practices in medicine and in medical education. It uses a study of anaesthetists' approaches to practice, and of lectures in problem-based learning, to illustrate the influence of a conception of 'applying knowledge in, or to, practice' and of its apparently...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1046/j.1365-2753.2000.00264.x
更新日期:2000-08-01 00:00:00
abstract:RATIONALE, AIMS, AND OBJECTIVES:The main purpose of this paper is to measure the efficiency and ranking of medical diagnostic laboratories by applying a network data envelopment analysis (NDEA). METHODS:In this study, each medical diagnostic laboratory is considered as a decision-making unit (DMU), and an NDEA model i...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/jep.13337
更新日期:2020-10-01 00:00:00
abstract:RATIONALE, AIMS AND OBJECTIVES:The incidence of falls and fall-related injuries in older age is predicted to increase concomitantly with global population ageing, representing a serious challenge to health care systems. In spite of the availability of policy and practice guidelines for the prevention of falls and fall-...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/j.1365-2753.2009.01307.x
更新日期:2010-12-01 00:00:00
abstract::A previous study (Stanhope et al. 1998) established that staff in two obstetric units reported less than a quarter of designated incidents to the units' risk managers. A questionnaire was administered to 42 obstetricians and 156 midwives at the same two obstetric units, exploring the reasons for low rates of reporting...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1046/j.1365-2753.1999.00147.x
更新日期:1999-02-01 00:00:00
abstract::It is common for primary care providers (PCPs) to manage complex multimorbidity. When caring for patients with multimorbidity, PCPs face challenges to tackle several issues within a short consultation in order to address patients' complex needs. Furthermore, some PCPs may lack access to a multidisciplinary team and ne...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/jep.13163
更新日期:2019-12-01 00:00:00
abstract:OBJECTIVE:The study aims to obtain the mean relative weights (MRWs) of the cost of care through the retrospective application of the adjusted clinical groups (ACGs) in several primary health care (PHC) centres in Catalonia (Spain) in routine clinical practice. METHODS:This is a retrospective study based on computerize...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/j.1365-2753.2012.01818.x
更新日期:2013-04-01 00:00:00
abstract:RATIONALE, AIMS AND OBJECTIVES:A common approach to assessing treatment effects in nonrandomized studies with time-to-event outcomes is to estimate propensity scores and compute weights using logistic regression, test for covariate balance, and then estimate treatment effects using Cox regression. A machine-learning al...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/jep.12859
更新日期:2018-04-01 00:00:00
abstract:AIM:To measure the impact of French national consensus guidelines on the clinical practices of primary care paediatricians and general practitioners. DESIGN:Non-randomized intervention study, with a first survey 1 year before the consensus development conference and a second survey 1 year after. INTERVENTION:Implemen...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/j.1365-2753.2007.00781.x
更新日期:2007-08-01 00:00:00
abstract::Evidence-based medicine (EBM) calls for medical practitioners to "integrate" our best available evidence into clinical practice. A significant amount of the literature on EBM takes this integration to be unproblematic, focusing on questions like how to interpret evidence and engage with patient values, rather than cri...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/jep.13109
更新日期:2019-12-01 00:00:00
abstract:OBJECTIVES:To describe the practices of physicians on the diagnosis and treatment of antituberculosis drug-induced hepatotoxicity (ATH), and to evaluate the concordance between these practices and the American Thoracic Society (ATS) 2006 guidelines. METHODS:Information was reviewed on 670 new cases of tuberculosis pat...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/j.1365-2753.2011.01706.x
更新日期:2012-12-01 00:00:00
abstract:RATIONALE:The ADAPTE framework was established to enhance efficiency in guideline development and to facilitate adaptation of high-quality clinical practice guidelines for a local context. It offers guideline developers a systematic methodology for guideline adaptation; however, the feasibility and usability of the pro...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/jep.12097
更新日期:2014-04-01 00:00:00
abstract:OBJECTIVE:Quality of life (QoL) is an important consideration in the care of patients with chronic neuromuscular disorder (NMD). The current study sought to determine the factor structure of the Medical Outcomes Study Short-Form 36 (SF-36) version 2 in patients with NMD to determine the appropriateness of using this in...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/j.1365-2753.2010.01513.x
更新日期:2012-02-01 00:00:00
abstract:RATIONALE AND OBJECTIVES:The effect of the presence of pressure ulcers on burden of caregivers is unknown. We investigated the relationship between the state of pressure ulcers in vulnerable elderly patients and the burden on their informal caregivers. METHODS:This cross-sectional study enrolled 137 patients aged > or...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/j.1365-2753.2009.01171.x
更新日期:2010-06-01 00:00:00
abstract::Work on resilience in health and illness has been approached from a number of perspectives. These are the biological and psychosocial with a focus on the individual's responses to cope and adapt to changing circumstances wrought by changing physical health states. This we argue has a place but is far too narrow emphas...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/jep.12955
更新日期:2018-12-01 00:00:00
abstract:RATIONALE, AIMS AND OBJECTIVES:Traditional continuing medical education programmes that offer passive learning have been shown to be poorly effective at changing doctors' clinical behaviour. A multifaceted evidence-based medicine (EBM) intervention was conducted at the largest health maintenance organization (HMO) in I...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章,随机对照试验
doi:10.1111/j.1365-2753.2007.00859.x
更新日期:2007-08-01 00:00:00
abstract:RATIONALE, AIMS AND OBJECTIVES:Little is known about the quality of occupational health care provided to National Health Service (NHS) staff. We designed the first national clinical audits of occupational health care in England. We chose to audit depression and back pain as health care workers have high levels of both ...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/j.1365-2753.2010.01574.x
更新日期:2012-04-01 00:00:00
abstract:RATIONALE, AIMS, AND OBJECTIVES:Measures of safety climate are increasingly used to guide safety improvement initiatives. However, cost and respondent burden may limit the use of safety climate surveys. The purpose of this study was to develop a 15- to 20-item safety climate survey based on the Patient Safety Climate i...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/jep.12731
更新日期:2017-08-01 00:00:00
abstract:RATIONALE, AIMS AND OBJECTIVES:Existing literature suggests that doctors' poor adherence with guidelines is one of the major contributing factors to suboptimal control of hypertension. This study aims to evaluate doctors' adherence with Malaysian clinical practice guideline (CPG 2008) in a tertiary care hospital, and f...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/j.1365-2753.2012.01852.x
更新日期:2013-10-01 00:00:00
abstract::The whole spectrum of medicine consists of complex non-linear systems that are balanced and interact with each other. How non-linearity confers stability on a system and explains variation and uncertainty in clinical medicine is discussed. A major theme is that a small alteration in initial conditions may have a major...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1046/j.1365-2753.2003.00344.x
更新日期:2003-05-01 00:00:00
abstract:RATIONALE:This paper reports an initiative which promoted evidence-based practice in pressure risk assessment and management among home nursing clients in Melbourne, Australia. AIM AND OBJECTIVES:The aim of this study was to evaluate the introduction and uptake of the Australian Wound Management Association Guidelines...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/j.1365-2753.2012.01870.x
更新日期:2013-10-01 00:00:00
abstract:OBJECTIVES:The aim of this study was to examine the impact of the use of an inter-professional care team on patient length of stay and payer charges in a geriatric transitional care unit. METHODS:An analysis of de-identified administrative records for transitional care patients for the 12-month period (2003-2004) care...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/j.1365-2753.2008.01114.x
更新日期:2010-02-01 00:00:00
abstract:RATIONALE:Clinical reasoning lies at the heart of medical practice and has a long research tradition. Nevertheless, research is scattered across diverse academic disciplines with different research traditions in a wide range of scientific journals. This polyphony is a source of conceptual confusion. AIMS AND OBJECTIVE...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/jep.13432
更新日期:2020-06-22 00:00:00
abstract:RATIONALE, AIM AND OBJECTIVE:As the prescribing of drugs in secondary care is known to influence prescribing in primary care and because an understanding of prescribers' reasoning is essential for evaluating prescribing appropriateness, the aim of this study was to investigate secondary care doctors' views of appropria...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/j.1365-2753.2008.00963.x
更新日期:2009-02-01 00:00:00
abstract:RATIONALE, AIMS AND OBJECTIVES:The onset of acute illness may be accompanied by a profound sense of disorientation for patients. Addressing this vulnerability is a key part of a physician's purview, yet well-intended efforts to do so may be impeded by myriad competing tasks in clinical practice. Resolving this dilemma ...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/jep.13410
更新日期:2020-05-07 00:00:00
abstract::There have been considerable political and organizational moves to involve 'consumers' (patients, carers, service users, potential users, local communities and the public at large) in the provision, planning and monitoring of health services. Such developments beg the question 'what constitutes good practice in user i...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章,评审
doi:10.1111/j.1365-2753.1996.tb00034.x
更新日期:1996-05-01 00:00:00
abstract:RATIONALE, AIMS AND OBJECTIVES:Day surgery is evolving, with a majority of recoveries occurring at home. There is, in parallel, an evolution in telemedical technology. The aim of the present project was to identify patients' willingness to use predefined follow-up techniques and to clinically test preferred techniques ...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/jep.12551
更新日期:2016-12-01 00:00:00
abstract:RATIONALE, AIMS AND OBJECTIVES:Short-term intensive insulin therapy (IIT) early in the course of type 2 diabetes can improve pancreatic beta-cell function and even induce normoglycemia that persists post-therapy. In spite of this benefit, insulin is often delayed until late in the course of disease partly because of it...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/j.1365-2753.2010.01552.x
更新日期:2012-04-01 00:00:00
abstract:RATIONALE, AIMS, AND OBJECTIVES:Human brain connectome is a new and rapidly developing field in neuroscience. The pattern of structural and functional connectivity in the brain is not fixed but is continuously changing in response to experiences. Exploring these phenomena opens a powerful arsenal of analyses and comput...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/jep.12911
更新日期:2018-08-01 00:00:00