Promoting Awareness of Resources Available at Syringe Exchanges in Windsor County, VT

Heroin addiction is a problem nationwide, and is especially prevalent in the state of Vermont. Individuals who inject heroin are at risk of infection with HIV or hepatitis C, and of death by heroin overdose. Currently, two syringe exchange sites operate in Windsor County in Vermont, located in White River Junction, VT, and Springfield, VT. These programs distribute clean syringes to prevent the spread of HIV and hepatitis C, sharps containers to promote safe disposal of dirty needles, and naloxone to prevent deaths from opioid overdose. They also provide testing for HIV and hepatitis C and information regarding local resources for treatment and recovery from substance abuse. This project aimed to increase awareness of the resources available at syringe exchange sites in Windsor County by means of a pamphlet distributed to clients of these programs.https://scholarworks.uvm.edu/fmclerk/1346/thumbnail.jp

Diagnostic Medical Errors: Patient\u27s Perspectives on a Pervasive Problem

Introduction. The Institute of Medicine defines diagnostic error as the failure to establish an accurate or timely explanation for the patient\u27s health problem(s), or effectively communicate the explanation to the patient. To our knowledge, no studies exist characterizing diagnostic error from patient perspectives using this definition. Objective. We sought to characterize diagnostic errors experienced by patients and describe patient perspectives on causes, impacts, and prevention strategies. Methods. We screened 77 adult inpatients at University of Vermont Medical Center and conducted 27 structured interviews with patients who experienced diagnostic error in the past five years. We performed qualitative analysis using Grounded Theory. Results. In the past five years, 39% of interviewed patients experienced diagnostic error. The errors mapped to the following categories: accuracy (30%), communication (34%) and timeliness (36%). Poor communication (13 responses) and inadequate time with doctors (7) were the most identified causes of errors. Impacts of errors included emotional distress (17 responses), adverse health outcomes (7) and impaired activities of daily living (6). Patients suggested improved communication (11 responses), clinical management (7) and access to doctors (5) as prevention strategies. For communication, patients rated talk to your doctor highest (mean 8.4, on 1-10 Likert scale) and text message lowest (4.8). Conclusions/Recommendations. Diagnostic errors are common and have dramatic impact on patients\u27 well-being. We suggest routine surveillance to identify errors, support for patients who have experienced errors, and implementation of patient and provider checklists to enhance communication. Future studies should investigate strategies to allow care providers adequate time with patients.https://scholarworks.uvm.edu/comphp_gallery/1246/thumbnail.jp