Background: With advancing age, increased susceptibility to injury and illnesses occur. The resulting physical disabilities often require home durable medical equipment (DME). Items such as hospital beds and Hoyer lifts require assembly in the patient's home. The purpose of this study is to assess the impact of home DME setup on efficient hospital discharge in trauma and non-trauma patients. Method: We retrospectively analyzed the records of 1,415 trauma and non-trauma patients requiring home DME over 30 months at an urban level-1 trauma center. We evaluated hospital length of stay (LOS) and DME-related costs between groups as our primary and secondary outcome measures. Other variables studied included demographics, injury patterns and admitting diagnoses.
Objectives & BackgroundTrying to establish an alternative e-learning tool to provide medical education to a country in need of support for the slowly growing medical community at undergraduate and postgraduate level. Following a devastating civil war in 1991, Somaliland is suffering a shortage of healthcare workers. King's College London has been working in partnership with educational institutions and healthcare providers in Somaliland since 2000.Methods6 sessions over a period of 8 weeks were arranged to deliver teaching on topics such as clinical examination or discussion of various clinical ETAT/APLS/NLS scenarios trying to focus on clinical reasoning and emergency management skills. The London based participants were a paediatric emergency department registrar, present in all sessions, and occasionally paediatric FY1 doctors and one medical student. The participants on the Somaliland side were paediatric lecturers and occasionally several final year medical students and intern doctors. It was decided to use Skype and compare whether its audiovisual and text functions would bring additional benefits compared with an already established instant messenger type web-based portal.ResultsThe initial feedback was positive and all participants agreed that Skype added a useful alternative to the still limited repertoire of distant learning opportunities. 100% of participants felt Skype with its audiovisual functions to be a very useful alternative to the existing teaching tool. 2 sessions had to be cancelled due to network problems. There were also connection issues in more than half of the other sessions. Over 80% of the participants would like more teaching in the form of Skype sessions. All participants identified network issues as a disadvantage and limiting factor.ConclusionDelivering distant online teaching sessions via Skype with its audiovisual functionality instead of purely text based online services clearly offers more advantages especially during clinical examination based or simulation sessions. It can currently only serve as an occasional teaching adjunct due to network instabilities and limited wifi availabilities in clinical areas mainly on the Somaliland teaching sites. Providing written and video materials in advance of Skype sessions will be tested in the future in order to use available time online more effectively.
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