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Related Concept Videos

Secondary Healthcare System01:11

Secondary Healthcare System

Secondary healthcare is offered by a specialist, generally in hospitals or clinics for patients referred by primary healthcare providers. It occurs when a person has an illness or injury that requires specific medical care. Secondary care is often referred to as acute care. Secondary care can range from uncomplicated care to repair a minor laceration or treat a strep throat infection to more complicated emergent care, such as treating a head injury sustained in an automobile accident. Whatever...
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Continuous Renal Replacement Therapy

Continuous Renal Replacement Therapy, also known as CRRT, is a procedural treatment for acute kidney injury (AKI) that gradually removes uremic toxins and fluids while maintaining acid-base balance and stabilizing electrolytes. It is particularly useful for hemodynamically unstable patients. Unlike intermittent hemodialysis, which is faster, CRRT provides a gentler approach over 24 hours, closely mimicking the function of natural kidneys. However, CRRT is not ideal for patients with...
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Esophageal Varices-II: Clinical Features and Management

Esophageal varices often manifest as gastrointestinal bleeding episodes, presenting symptoms like hematemesis (vomiting of blood), hematochezia (passing fresh blood via the rectum), and melena (black, tarry stools). Other signs can include weight loss, anorexia, abdominal discomfort, jaundice, pruritus, altered mental status, and muscle cramps.
In the initial assessment, a thorough review of the patient's medical history is vital to identify risk factors such as liver disease, alcohol abuse, or...
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Angle Closure Glaucoma: Treatment

Angle-closure glaucoma, or closed-angle glaucoma, is an eye condition where the iris bulges out and blocks the iridocorneal angle, resulting in a buildup of aqueous humor and increased intraocular pressure. Immediate medical attention is necessary due to the sudden onset of symptoms. The treatment for angle-closure glaucoma includes short-term and long-term approaches. Short-term treatment involves using eye drops like pilocarpine to lower intraocular pressure by increasing aqueous humor...
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...
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Acute Coronary Syndrome IV: Interprofessional Care

IntroductionThe management of Acute Coronary Syndrome (ACS) aims to minimize myocardial damage, preserve myocardial function, and prevent complications.Initial ManagementInpatient management involves continuous cardiac monitoring, preferably in an ICU, focusing on blood pressure, serum sodium, potassium, and creatinine levels, and urine output. Ongoing pharmacologic management is crucial for stabilizing the patient.Supplemental Oxygen: Administer supplemental oxygen if oxygen saturation is...

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Anterior Segment Organ Culture Platform for Tracking Open Globe Injuries and Therapeutic Performance
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Eye casualty services in London.

H B Smith1, C S Daniel, S Verma

  • 1Eye Casualty Department, Moorfields Eye Hospital, London, UK. hbs@doctors.net.uk

Eye (London, England)
|February 2, 2013
PubMed
Summary

Consolidating emergency eye care services in London increased demand at remaining units. A new referral pathway was developed to improve efficiency and patient travel, addressing unintended consequences of service changes.

Area of Science:

  • Ophthalmology
  • Healthcare Management
  • Public Health

Background:

  • European Working Time Directive, 4-hour waiting targets, and rising unplanned attendances have led to eye casualty department consolidation.
  • Remaining eye casualty services face rapidly increasing patient demand.
  • This study examines the impact of these changes on emergency eye care provision in Central London.

Purpose of the Study:

  • To analyze the effects of eye casualty service consolidation on emergency eye care delivery in Central London.
  • To identify lessons learned from service consolidation for wider application.
  • To propose strategies for managing increased demand and improving patient pathways.

Main Methods:

  • Survey of managers from 8 out-of-hours eye casualty services in London.

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  • Analysis of attendance data from key London eye units.
  • In-depth interviews with lead clinicians at major eye casualty departments.

    • Main Results:

    • Annual attendance at Moorfields Eye Hospital and Western Eye Hospital increased by 7.9% and 9.6% respectively.
    • Service consolidation resulted in patients traveling longer distances to potentially inappropriate units.
    • Confusion arose regarding out-of-hours inpatient care responsibilities.

    Conclusions:

    • Increased demand necessitates strategies to enhance capacity and efficiency in emergency eye care.
    • Service consolidation can lead to unintended consequences like increased patient travel and unclear responsibilities.
    • A novel referral pathway was developed to minimize patient travel and delays, with a call for strategic planning of London's eye casualty services.