Related Experiment Videos

Peripatetic intravenous service for metabolic bone disease: case study in patient centred-care for new NHS

Michael Davie1, Paula Jeffreson, Teresa Jones

  • 1The Robert Jones and Agnes Hunt Orthopaedic and District Hospital NHS Trust, Oswestry, Shropshire, UK. mike.davie@rjah.nhs.uk

Current Medical Research and Opinion
|July 6, 2010
PubMed

Insights

A new peripatetic intravenous service (PIVS) for osteoporosis care is cost-neutral, improves patient convenience, and reduces the NHS carbon footprint. This community-based model offers significant mileage and CO(2) savings compared to traditional hospital visits.

Area of Science:

  • Health Services Research
  • Osteoporosis Management
  • Sustainable Healthcare

Background:

  • Delivering specialist osteoporosis care often involves significant patient travel to hospital.
  • Conventional treatment models can contribute to a substantial carbon footprint and incur patient costs.
  • There is a need for accessible, cost-effective, and environmentally friendly healthcare delivery models.

Purpose of the Study:

  • To develop and evaluate a 'close to patient' peripatetic intravenous service (PIVS) for osteoporosis care.
  • To assess the cost-neutrality and feasibility of PIVS in a community setting.
  • To determine the impact of PIVS on patient experience, travel, and carbon footprint.

Main Methods:

  • A peripatetic intravenous service (PIVS) for bisphosphonate treatment was modelled using UK NHS costings.
  • The model was field-tested for one year, comparing patient mileage and travel methods to current hospital-based practice.
  • Patient satisfaction, cost per patient, and CO(2) emissions were the primary outcome measures.

Main Results:

  • PIVS was found to be cost-neutral, with annual costs between £557-£622 per patient.
  • 98% of patients rated the PIVS as more convenient than hospital attendance.
  • The service significantly reduced hospital transport, saving 2000 miles monthly and 6072 kg CO(2) annually, with no medical emergencies in 410 infusions.

Conclusions:

  • Peripatetic intravenous service (PIVS) is a viable, cost-neutral alternative to conventional osteoporosis care.
  • PIVS enhances patient experience and substantially reduces the NHS carbon footprint and transport costs.
  • The suitability of PIVS may vary by drug type and geographic area (e.g., rural vs. urban).
Abstract

Related Concept Videos

Chronic Kidney Disease III: Interprofessional Care01:28

Chronic Kidney Disease III: Interprofessional Care

Chronic kidney disease (CKD) requires collaborative and comprehensive management. CKD progresses through stages and can lead to end-stage kidney disease (ESKD) if untreated. Interprofessional collaboration and patient education are crucial, enabling patients to manage their health and improve their quality of life.Diagnostic approach for chronic kidney diseaseThe diagnosis of CKD primarily focuses on the glomerular filtration rate (GFR), which assesses kidney function by measuring how well...
Hemodialysis III: Nursing Management01:25

Hemodialysis III: Nursing Management

The nursing management of a patient undergoing hemodialysis includes several critical steps, starting with a thorough assessment before the procedure.Before the Hemodialysis ProcedureFirst, record the patient's vital signs—blood pressure, heart rate, respiratory rate, and temperature—to establish a baseline. This baseline is essential for detecting conditions such as hypotension that could impact the patient's response to dialysis. Document the patient's pre-dialysis weight, as this measurement...
Parentral Nutrition: Centeral and Peripheral Parental Nutrition01:27

Parentral Nutrition: Centeral and Peripheral Parental Nutrition

Parenteral Nutrition (PN) delivers essential nutrients directly into the bloodstream, bypassing the digestive system. It is commonly used for individuals with severe digestive disorders or conditions that prevent normal nutrient absorption.
PN can be administered through two primary routes:
1. Central Parenteral Nutrition (CPN):
CPN involves delivering a high concentration of nutrients through a large vein. This is typically achieved using a Peripherally Inserted Central Catheter (PICC) or,...
Acute Kidney Injury V: Interprofessional Care01:20

Acute Kidney Injury V: Interprofessional Care

Acute Kidney Injury (AKI) requires a collaborative healthcare approach to restore renal function and prevent complications. Essential management strategies involve monitoring fluid and electrolyte balance, adjusting medications, initiating dialysis when necessary, and providing nutritional support.Fluid and Electrolyte ManagementFluid Monitoring: Regularly monitoring body weight, central venous pressure, and urine output helps detect fluid imbalances early. Patient intake and output are...
Chronic Kidney Disease IV: Nursing Management01:18

Chronic Kidney Disease IV: Nursing Management

Nursing management is essential for preventing complications, maintaining stability, and improving patients' quality of life in chronic kidney disease (CKD). By using a structured approach, nurses help slow CKD progression and support effective patient care​.1. Comprehensive patient assessmentEffective management begins with nurses reviewing the patient’s medical history, and identifying key risk factors like diabetes, hypertension, and nephrotoxic drug use. Nurses assess signs of fluid...
Peritoneal Dialysis III: Nursing Management01:25

Peritoneal Dialysis III: Nursing Management

Peritoneal dialysis, or PD, utilizes the peritoneal membrane as a filter to eliminate excess fluid and waste products. Effective nursing management is essential for ensuring patient safety, preventing complications, and promoting optimal function of the peritoneal dialysis process.Assessment and MonitoringNurses must thoroughly assess the patient before, during, and after each dialysis session. Regular monitoring includes vital signs, daily weight, fluid intake and output, and laboratory values...