How to Improve Assessment of Tetanus Immunity in the Emergency Room: A Prospective Cost-Effectiveness, Double Blind Study

peer reviewe

ESICM LIVES 2022: part 2.

peer reviewe

Safety and Reliability - Safe Societies in a Changing World

The contributions cover a wide range of methodologies and application areas for safety and reliability that contribute to safe societies in a changing world. These methodologies and applications include: - foundations of risk and reliability assessment and management - mathematical methods in reliability and safety - risk assessment - risk management - system reliability - uncertainty analysis - digitalization and big data - prognostics and system health management - occupational safety - accident and incident modeling - maintenance modeling and applications - simulation for safety and reliability analysis - dynamic risk and barrier management - organizational factors and safety culture - human factors and human reliability - resilience engineering - structural reliability - natural hazards - security - economic analysis in risk managemen

Acute oncology service = Acute palliative service? Early palliative care assessment results from a pilot project in South Wales

Background: The National Chemotherapy Advisory Group report 2009 recommends an acute oncology service (AOS) in every UK hospital with an emergency department. Patients discussed in Acute Oncology Service settings are often very unwell, at the start of their cancer journey, and may have multiple challenging symptoms. Aims: Will earlier palliative care intervention in AOS meetings result in an increase in palliative care involvement? As a comparative baseline we used data from Royal Sussex County Hospital, where an acute admission AOS data collection was carried out: in 53 patients with cancer, palliative care were involved in four cases (7.5%). Methods: As part of this project, our palliative care team started to attend AOS meetings at Velindre Cancer Hospital on a daily basis. After initial embedding, a strategy to collect data was designed and an audit cycle was carried out. Results: Through integration of the palliative care team into Acute Oncology Service meetings, key areas of advance care planning were addressed and discussions with patients were planned. Of 100 patients assessed during the AOS reporting period, 80% were not known to a palliative care team/provider. Of all patients analysed, 28% required no palliative input, 29% were signposted to another palliative care team, 27% received same day face to face palliative care review and 16% required verbal advice only to a generalist team member. Advance care planning discussions in the sample of patients who needed some palliative care input were held within a two week time frame in 61% of cases. Discussion: Significant findings included large population (80%) unknown to palliative care services at AOS entry point, but with high level of unmet need. 72% had palliative care needs. 29% had received their cancer diagnosis within the last month. Conclusion: AOS meetings appear to be a valid entry point for referral to palliative services, despite many AOS patients being at the start of their cancer diagnosis