Effective Patient Care

Patient Care and Clinical Testing and Treatment

Covid 19 Coronavirus Patient Care

Am I high risk?

People with cancer are at higher risk from Covid-21 but no information specifically for valve disease exists. It is likely that mild or moderate valve disease does not increase the risk. This includes people with valves that function well. However, it is likely that severe valve disease can increase risk particularly if it is associated with symptoms (usually breathlessness or chest tightness on exertion). You may also be at higher risk if you have had surgery for Patient Care disease in the past 3 months. If your surgery was longer ago than this, then you are not expected to be at higher risk unless the repaired or replaced functions is not working normally or your heart is not pumping blood normally (i.e. left ventricular function is reduced).

 

What should I do if I develop symptoms from the valve disease?

If you develop new and especially progressive breathlessness or chest tightness on exertion, you should contact your GP who usually supervises your care for a covid vaccine private. People with very severe valve disease may still need surgery despite the current covid-19 epidemic. This is a judgement for your specialist and the arrangements for care will vary depending on local arrangements.

 

I was scheduled to have surgery and have now been told it will be delayed. Should I be worried?

Although many planned / scheduled operations will be delayed by the coronavirus outbreak, it is important for you to be reassured that there will always be provision in the NHS to provide urgent or life-threatening operations for patients that need it. If your planned procedure has been delayed, you should monitor any symptoms and let the hospital team know if you experience any deterioration (e.g. increasing breathlessness on exertion, new chest pain on exertion, or dizziness on exertion).

 

I have a metallic / mechanical Patient Care and it is difficult to get INR checks at present. Should I switch from warfarin to heparin injections?

The reasoning behind this question is the hope of avoiding visits to the GP or hospital for blood tests. However, if you are taking warfarin because of a mechanical replacement valve, heparin injections are not as good as warfarin medication as there is a higher risk of developing blood clots on the valve. Therefore, continuing on warfarin is the best option for you if this is possible. Some anticoagulation clinics are suggesting home testing where there is adequate back-up from district nurses. Other clinics are sending transport to avoid patients needing to use public transport. Most clinics are trying to space out appointments to maintain ‘social distancing’. You should only switch to heparin injections if INR testing is proving very challenging and this is the advice of your local cardiologist after discussing with you the risks and benefits of this change.

 

If I develop a fever, do I need to think of infective endocarditis?

The main symptoms of Covid-19 are fever, a dry cough and breathlessness. Some people experience diarrhoea and some have loss of taste. Other than the fever these symptoms are not typical of infective endocarditis. Currently Covid-19 is all too common while infective endocarditis is still uncommon. This means that a fever is more likely to be caused by Covid-19. If, however, you are severely unwell you need to phone 111 whatever the cause. If you have a more minor fever lasting longer than a week you should ask your GP for advice especially if you have severe gum disease or an untreated tooth infection.

 

Should I stop any of my medications?

There have been questions over whether angiotensin blocking medicines (e.g. “ACE inhibitors”) might worsen the effects of Covid-19. However, there is also some evidence that these drugs may be protective. All major international cardiac authorities agree that you should not stop angiotensin converting enzyme inhibiting drugs or angiotensin receptor blockers. No other drug has attracted concern to date

Finally, the British Patient Care Society would like to re-iterate that the best way to stay safe during this viral pandemic is to follow the Government’s and NHS England’s advice:

  • Wash your hands often, using soap and water for at least 20 seconds. Use an alcohol-based hand gel if soap and water are not available.
  • Avoid touching your eyes, nose, and mouth
  • Avoid close contact with people who are sick
  • If you feel unwell, stay at home, do not attend work or school

Zeltiq CoolSculpting

CoolSculpting® by Zeltiq™, a revolutionary new FDA-cleared, non-invasive treatment that reduces love handles and other targeted areas by freezing and removing fat cells. The science behind Zeltiq CoolSculpting is called Cryolipolysis™, which is a precisely controlled cooling method that targets, cools, and eliminates fat cells without damaging your skin. The treatment works by using a mild vacuum pressure on targeted abdominal tissue exposing cells to cold temperatures and ‘freezing’ them. CoolSculpting® treatment is virtually pain-free and only takes about 1-2 hours, after the treatment you can immediately resume daily activities and Zeltiq London is available from many Harley St Clinics

Several days after the procedure, the cooled fat cells begin a process called “apoptosis” and begin to shrink. These damaged fat cells are naturally digested and eliminated after several months resulting in a slimmer shape of the body. You may see results as early as three weeks following treatment and your results will continue over the next two to four months. On average, patients will experience a 20-25% reduction of fat in the treated area after one visit (sometimes combined with Laser Hair Removal and may lose more with additional visits.

Fat Removal

The science behind CoolSculpting london ® is called Cryolipolysis™, which is a precisely controlled cooling method that targets, cools, and eliminates fat cells without damaging your skin. You may see results as early as three weeks following treatment and your results will continue over the next two to four months as the crystallized fat cells break down and your body naturally flushes them.

Patient Safety

The misuse and overuse of medicine and medical procedures jeopardize patient safety.

Unnecessary hospitalizations and unwanted surgeries expose patients unnecessary risks.

Opinion Research Results

This research programme investigated the effectiveness of web-based feedback to drive quality improvement in the health service and patient care.

The research was conducted by studying various websites and undertaking Internet Marketing with various partners. Patient Opinion is a not-for-profit social enterprise which runs the website, enabling patients to share their experiences online. Health organisations, particularly hospitals, are then able to view these comments and respond, for example by explaining any changes they have put in place as a result of criticism.

The research based on the Patient Opinion website addressed a number of questions:

  • In what ways do existing NHS complaints and feedback mechanisms fall short?
  • How might web-based approaches overcome these limitations?
  • In practice, how far are web-based feedback systems actually overcoming existing limitations?
  • What factors need to be present in a healthcare organisation for web-based feedback systems to meet the needs of service users and lead to quality improvement?
  • Are there particular advantages or disadvantages to an independent web-based feedback system, compared with an NHS-run system?

The research began with an online and postal survey sent out to 1,236 people who had used the Effective Patient Care website. The response rate was 40.45% (500 responses). This was followed up with individual interviews with users.

The research also included a comparison with other web-based feedback systems, by studying non-public sector websites, including customer discussion forums, market research communities, Candy Crush game download, democracy and transparency websites and purchasing/booking websites.

Treatments

Patient care is a core guiding principle of the medical profession.

With the increasing diversity in the range of drugs, treatments and the rising popularity of non medical surgery and cosmetic medicine it is essential that all medical practionioners and doctors follow safe and verfied procedures for “lifestyle” medicine.

With the outbreak of the pandemic then Private Coronavirus Testing is critical to ensuring patient care and safety.

A number of lifestyle treatments are now available and effective patient care is essential in the following grey area:

 

Links

The organizations below are engaged in important work related to evidence based medicine:

Alliance for Better Health Care www.chsr.org/abhc.htm – ABHC seeks to promote comparative effectiveness research (CER) and its distribution through advocacy-supporting efforts. These efforts aim to: increase federal funding for CER; identify knowledge gaps and prioritize where further research is needed; broadly disseminate research findings to clinicians, patients, and others; and encourage the application of comparative effectiveness in clinical practice by presenting research findings in formats understandable to different audiences.

Harley St Clinic – leading website portal and guide to the Harley St world of private medicine. With a vast and sometimes confusing range of clinics, hospitals and treatments available we offer a guide to Harley St. There are over 300 Harley St Hospitals and most offer some of the best clinicians and treatments to be found anywhere – popular treatments cover laser hair removal, best cosmetic surgery practice . In addition a number if world-renowned surgeons and Doctors operate out of Harley St and they offer a range of leading treatment and advice.
American Association of Retired Persons www.aarp.org – AARP is a nonpartisan membership organization for people age 50. It operates as a nonprofit advocate for its members and as one of the most powerful lobbying groups in the United States, with more than 35 million members.

Association for Healthcare Research and Quality — Evidence-based Practice Centers www.ahrq.gov/clinic/epcix.htm – Under the Evidence-based Practice Centers (EPC) Program of the Agency for Healthcare Research and Quality, 5-year contracts are awarded to institutions in the United States and Canada to serve as EPCs. The EPCs review all relevant scientific literature on clinical, behavioral, and organization and financing topics to produce evidence reports and technology assessments. These reports are used for informing and developing coverage decisions, quality measures, educational materials and tools, guidelines, and research agendas. The EPCs also conduct research on methodology of systematic reviews.

Blue Shield of California www.blueshieldca.com/bsc/home – A San Francisco-based, not-for-profit health plan dedicated to providing Californians with access to high-quality health care at a reasonable price. It serves 3.2 million health plan members and nearly 59,000 physicians across the state.

California Association of Physician Groups www.capg.org/home/index.asp – Comprised of more than 150 of Californiaís leading physician groups — who provide health care to approximately 13 million Californians — CAPG is the nationís largest professional association representing physician groups practicing in the managed care model. More than fifty percent of California’s health care is delivered by physicians employed by or contracted with CAPG members.

California Healthcare Foundation www.chcf.org – An independent philanthropy committed to improving the way health care is delivered and financed in California, CHCF commissions research and analysis, publishes and disseminates information, convenes meetings of key health care groups, and funds development of programs and models aimed at improving health care in California.

Center for Healthcare Decisions www.chcd.org – Understanding there are no easy answers in healthcare policy, the Center for Healthcare Decisions is dedicated to advancing healthcare that is fair, affordable and reflects the priorities of an informed public. CHCD wants policy leaders to understand how average people express priorities and values and works collaboratively with other stakeholders looking to improve healthcare policy and practice.

Consumer-Purchaser Disclosure Project http://healthcaredisclosure.org – A group of leading employer, consumer, and labor organizations working toward ensuring that all Americans have access to publicly reported health care performance information. Their efforts and advocacy are focused on encouraging development of quality measures relevant to consumers and purchasers; promoting the endorsement of a robust set of performance measures; and enhancing the availability of data to support public reporting.

Consumer Report Best Buy Drugs www.consumerreports.org/health/best-buy-drugs/index.htm – A public education project to help patients talk with their doctors about prescription drugs. Helps patients identify the most effective and safe drugs and the best value for their health care dollar. The site also features tables to help calculate monthly savings and alerts that track the safety and off-label use of prescription drugs.

The California Technology Assessment Forum http://www.ctaf.org – CTAF is a public service forum that assesses new and emerging medical technology. CTAF is a community forum dedicated to objectivity and transparency regarding medical technologies and to dialog and decisions regarding the safety and effectiveness of new and emerging technologies. Their vision is a culture of patient care in which the use of medical technologies is based on scientific evidence.

Dartmouth Atlas of Health Care www.dartmouthatlas.org – For more than 20 years, The Dartmouth Atlas Project has documented glaring variations in how medical resources are distributed and used in the United States. Their reports have radically changed our understanding of the efficiency and effectiveness of our health care system, and form the foundation for many of the ongoing efforts to improve health and health systems across America.

ECRI www.ecri.org – is a nonprofit health services research agency and a Collaborating Center of the World Health Organization (WHO). It is designated as an Evidence-based Practice Center (EPC) by the U.S. Agency for Healthcare Research and Quality.

Foundation for Informed Medical Decision Making www.informedmedicaldecisions.org – The Foundation for Informed Medical Decision Making is a non-profit organization dedicated to advancing research, policy, and clinical models that assure patients understand their choices and have the information they need to make sound decisions affecting their health and well-being. The foundation considers the opportunity to engage in the process of shared decision-making to be a basic right of every patient.

Informed Patient Institute www.informedpatientinstitute.org – The Informed Patient Institute (IPI) is a nonprofit organization that provides credible online information about health care quality and patient safety for consumers through its website. The two types of consumer-oriented information IPI provides are: 1) assessment of the usefulness of the wealth of online report cards; and 2) information about what to do if you have a concern about health care quality with information relevant to California.

IOM Roundtable on Evidence-Based Medicine www.iom.edu/CMS/AboutIOM/28189.aspx – Through meetings, workshops, publications, and collaborative projects, the Roundtable promotes identification and engagement of key issues, barriers, and policy opportunities important to achieving its goal that by 2020, ninety percent of clinical decisions will be supported by accurate timely, and up-to-date clinical information, and will reflect the best available evidence.

National Partnership for Women & Families www.nationalpartnership.org – For 38 years, The National Partnership for Women and Families has played a critical role in enacting landmark policy from prohibiting pregnancy discrimination to giving families the opportunity to take the family and medical leave they need more than 100 million times. Today, among other things, they promote access to quality and affordable health care.

National Quality Forum http://qualityforum.org – NQF is a nonprofit organization working to improve the quality of healthcare for all Americans through: setting national priorities and goals for performance improvement; endorsing national consensus standards for measuring and publicly reporting on performance; and promoting the attainment of national goals through education and outreach programs. Their membership includes a wide variety of healthcare stakeholders.

New America Foundation www.newamerica.net – New America Foundation is a nonprofit, nonpartisan public policy institute that invests in new thinkers and new ideas to address the next generation of challenges facing the United States. The Health Policy Program at New America Foundation works to advance and protect a fact-based health reform dialogue. Bringing together economic, legal, communications, and legislative experience, the Health Policy Program interprets and responds to health policy news in real time, facilitates conversations between policymakers and stakeholders, and publishes policy papers on health care system problems and possible solutions.

Pacific Business Group on Health www.pbgh.org – PBGH is a respected voice in the state and national dialogue on how to improve the quality and effectiveness of health care while moderating costs. They work on many fronts to promote value-based purchasing in health care, and their 50 large purchaser members spend billions of dollars annually to provide health care coverage to more than 3 million employees, retirees and dependents.

Contact

Campaign for Effective Patient Care
22 Madrone Court
Fairfax, CA 94930(415) 457-1418
We will use our email list to inform you about new developments around evidence based medicine and to keep you up-to-date and involved in the work of the Campaign for Effective Patient Care. This is the only purpose for which we will use your information.

Mission

The Campaign for Effective Patient Care is an education and advocacy organization committed to fostering policies to improve patients’ health and health care.

Through policies that substantially increase the use of solid scientific evidence in the everyday practice of health care, patients can have greater confidence that they are receiving the right care, at the right time and in the right place.

We support policies that promote the use of up-to-date, trusted research so patients and their providers will make better, more informed decisions to improve patients’ health and well being.

One such example is insulin pumps and Treatment of insulin dependent diabetes involves the use of insulin therapy and providing insulin doses throughout the day. Today, there is an alternative to injecting insulin several times per day in accordance to basal/bolus control. The insulin pump is ideal for those diabetics who are very busy with their lives or for those whose blood sugar levels are very high and cannot be controlled by taking multiple insulin pump shots per day. Some pumps (from Harley Street Clinics) The pump provides a way of maintaining better control over blood glucose levels, thereby preventing or minimizing the onset of long-term complications associated with diabetes.

 

About

The Campaign for Effective Patient Care is a nonprofit 501(c)4 organization formed in 2009 with initial support from AARP, the California Association of Physician Groups, and Blue Shield of California. The Campaign for Effective Patient Care advocates for safe, scientifically-sound health care for all patients.

Through education and advocacy, the Campaign for Effective Patient Care will support work to help policymakers develop an understanding of how evidence-based medicine is essential to an effectively functioning health-care delivery system.

In the coming years, the Campaign for Effective Patient Care will work with policymakers to assure that the necessary infrastructure and incentives are in place to support the use of current, objective, scientific evidence in medical decision making by doctors and patients.