action had been taken to identify the episodes and notify the general practitioner (GP). Method A retrospective analysis of pacing clinic notes was made for 100 consecutive patients attending pacemaker interrogation.12 NEW cases of AF were diagnosed from the utilisation of pacemaker technology.1 (8%) of the 12 was already anticoagulated and documented.2 (17%) patients -no clear documentation of action taken e.g. GP informed.9 (75%) patients -clear documentation that GP had been informed and action had been taken.17 patients had episodes of MS greater than 30 s. 10 (59%) had intracardiac electrogram monitoring (EGM) activated and returned to clinic in two months time.1 (6%) patient had an older device with no EGM monitoring available and was fitted with a holter monitor.6 (35%) patients had no clear plan documented. A repeat retrospective analysis of 100 patients was made 6 months later and the results showed:19 NEW cases of AF were diagnosed. 3 (16%) of the 19 was already anticoagulated and documented.16 (84%) patients -clear documentation that GP had been informed and action had been taken.All patients were appropriately managed. 16 patients had episodes of MS greater than 30 s. 13 (81%) had EGM activated and returned to clinic in two months time.1 (6%) patient had an older device with no EGM monitoring available and was already anticoagulated.2 (13%) patients were nearing battery replacement and EGM storage was not activated to conserve battery life. Conclusion AF is highly prevalent in our pacemaker population. Utility of pacemaker technology by cardiac physiologists improved early detection and treatment of AF in 83% patients. This improved patient outcomes and reduced stroke risk significantly.Future improvements included a clear, auditable pathway for physiologists when AF is suspected/identified to ensure this is consistently communicated to patients and their doctors. This is reflected from the repeat retrospective study which has shown raising awareness can have an impact. Introduction Atrial fibrillation (AF) is one of the top ten reasons for hospital admissions. Failure to recognise this arrhythmia and risk stratify patients early on diagnosis can have detrimental consequences including high risk of thromboembolic events, stroke, heart failure and death. An audit conducted in our hospital (2011)(2012) revealed that patients with AF stay an average 5.6 days in hospital. It has been estimated that billions of pounds are spent each year from health and social care budgets due to AF and AF related strokes. Cardiac Rhythm Management1 To address this, a new service "Rapid access AF clinic (RAAFC)" was developed in our hospital in June 2012. This retrospective study explores the role of RAAFC on clinical outcomes since its introduction. Methods 210 patients were seen in our clinic between 01/06/ 2012 and 30/10/2015. 56 patients were excluded from the analysis --41 due to lack of access to records, 1 found to be in CHB and 14 in sinus rhythm. 154 patients were included in the final analysis. Patients were div...
Purpose The purpose of this paper is to review and critically evaluate UK psychiatry national recruitment process for 2021, which was re-structured following the COVID-19 pandemic. Additionally, this paper aims to review the empirical evidence of the selection methodologies in psychiatry recruitment. Design/methodology/approach The UK national psychiatry recruitment process is discussed, with a focus on the changes made to recruitment in 2021. The advantages and disadvantages of different selection methodologies are explored, with an emphasis on evaluating the validity, acceptability and reliability of different recruitment selection methodologies. The potential impact of the changes to psychiatry recruitment are explored. Findings The decision of the National Recruitment Office to remove certain selection methods for recruitment in 2021 may have limited their ability to choose the best candidate for the training place and be fair to the applicant. Overall, there is a lack of research into the validity of the selection methods used in psychiatry recruitment. A framework for outcome criteria relevant to psychiatry recruitment should be developed, which would allow research into selection methods and guide the NRO to examine the evidence base effectively. Originality/value This paper examined the recruitment methods used to choose doctors for psychiatry training in the UK, demonstrating that the empirical evidence base for psychiatry recruitment is limited. This paper can contribute to our understanding of selection methodologies used in psychiatry recruitment and highlights the value of different recruitment approaches for choosing the best psychiatrists of the future.
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