A Comparison of Women’s Travel to Mammography Services and Average Week Day Trip Length

Long travel distances/times to a mammography service may act as a barrier that hinders women from seeking screening mammography on a recommended schedule. Average weekday trip length data from the New South Wales Travel Survey was compared with the average distance women travelled to a mammography service, the difference was tested using the Wilcoxon Signed Rank Test. The distance travelled to mammography services was statistically greater than the average week day trip length from the New South Wales Travel Survey (4.3 km, 95% CI 3.3 to 5.9 kms, p,0.001). This study has identified that within New South Wales there is a significant difference between average week day trip length travel and client travel to mammography services. Therefore, highlighting that women are undertaking a greater than normal travel burden to access mammography services. The comparison of normal weekday travel and travel to mammography services has enabled the burden of travel to mammography services to be identified. Reducing the burden of travel to mammography services is pivotal to increasing the utilization of mammography services and reducing the inequalities in health comes

The role of informal dimensions of safety in high-volume organisational routines:an ethnographic study of test results handling in UK general practice

Abstract Background The handling of laboratory, imaging and other test results in UK general practice is a high-volume organisational routine that is both complex and high risk. Previous research in this area has focused on errors and harm, but a complementary approach is to better understand how safety is achieved in everyday practice. This paper ethnographically examines the role of informal dimensions of test results handling routines in the achievement of safety in UK general practice and how these findings can best be developed for wider application by policymakers and practitioners. Methods Non-participant observation was conducted of high-volume organisational routines across eight UK general practices with diverse organisational characteristics. Sixty-two semi-structured interviews were also conducted with the key practice staff alongside the analysis of relevant documents. Results While formal results handling routines were described similarly across the eight study practices, the everyday structure of how the routine should be enacted in practice was informally understood. Results handling safety took a range of local forms depending on how different aspects of safety were prioritised, with practices varying in terms of how they balanced thoroughness (i.e. ensuring the high-quality management of results by the most appropriate clinician) and efficiency (i.e. timely management of results) depending on a range of factors (e.g. practice history, team composition). Each approach adopted created its own potential risks, with demands for thoroughness reducing productivity and demands for efficiency reducing handling quality. Irrespective of the practice-level approach adopted, staff also regularly varied what they did for individual patients depending on the specific context (e.g. type of result, patient circumstances). Conclusions General practices variably prioritised a legitimate range of results handling safety processes and outcomes, each with differing strengths and trade-offs. Future safety improvement interventions should focus on how to maximise practice-level knowledge and understanding of the range of context-specific approaches available and the safeties and risks inherent in each within the context of wider complex system conditions and interactions. This in turn has the potential to inform new kinds of proactive, contextually appropriate approaches to intervention development and implementation focusing on the enhanced deliberation of the safety of existing high-volume routines

Analysis of Outcomes in Ischemic vs Nonischemic Cardiomyopathy in Patients With Atrial Fibrillation A Report From the GARFIELD-AF Registry

IMPORTANCE Congestive heart failure (CHF) is commonly associated with nonvalvular atrial fibrillation (AF), and their combination may affect treatment strategies and outcomes

The value of open-source clinical science in pandemic response: lessons from ISARIC

International audienc