Clinical and regulatory protocol for the treatment of jaundice in adults and elderly subjects: a support for the health care network and regulatory system

Abstract

PURPOSE: Clinical interventions and controlled access to the health care system can be improved by a Regulatory System (RS) and Clinical and Regulatory Protocols (CRPs). The objective of the present paper is to present the methodology used for elaborating the CRPs. METHODS: The process used to elaborate the CPRs involved a scientific co-operation between university and health care system. Workshops were held and attended by primary care practitioners, RS team, and matrix team (university specialists supporting primary care practitioners). RESULTS: The treatment of jaundice in adults and elderly subjects is amongst the themes selected for elaborating the CRPs since jaundice is a medical sign frequently seen in four clinical scenarios involving distinctive diagnostic and therapeutic interventions which can be performed in different health care settings. Evaluation guidelines as well as the clinical and regulatory procedures were established for different health care settings. The most relevant clinical and regulatory interventions were expressed as algorithms in order to facilitate the use of CRPs by health care practitioners. CONCLUSION: It is expected that the implementation of this protocol will minimise the imbalance between the icteric patients' needs and the treatment modalities being offered, thus contributing to a more co-operative health care network.

Clinical and regulatory protocols for the management of impaired vision in the public health care network

“…The rationale for regulating access to health care services is based on using primary care as a portal of entry, both in terms of elective needs and referral to other health providers (2)(3)(4)(5)(6)(7)(8)(9)(10)(11) . Emergency cases of low complexity can be addressed at the primary care level, whereas severe cases must be referred to emergency care facilities as required by the regulatory guidelines (3)(4)(5) .…”

“…Emergency cases of low complexity can be addressed at the primary care level, whereas severe cases must be referred to emergency care facilities as required by the regulatory guidelines (3)(4)(5) . The technical and regulatory components of the CRPs reflect the interactions among the facilities (hospitals, health care clinics, ambulance services, etc.)…”

“…Although implementation of the SUS has amplified the primary health care structure, inefficient clinical interventions and poor primary care coordination have resulted in excessive demand for specialized and emergency care services (3) . Measures adopted in order to streamline access to various health care services include the implementation of the Regulatory System (RS), which is aimed at mapping the allocation of health care resources and structuring the various regulatory bodies.…”

“…Medical teams and users can also consult the various RS units, the emergency unit in particular, by telephone, internet and fax (3)(4)(5) . Ineffective ophthalmologic interventions and limited knowledge of community eye health on the part of primary care providers have led to various problems related to local treatment and referral of ophthalmologic cases.…”

Ayurvedic Intervention for Hepatobiliary Disorders: Current Scenario and Future Prospect

“…Some Organic agents including certain naturally occurring plant toxins such as Pyrrolizidine alkaloids, mycotoxins and bacterial toxins have known hepato toxicity effect [12,13]. Jaundice is the commonest presentation of patients with liver and biliary disease [14]. The cause can be established in most cases by simple non-invasive tests, but many patients will require referral to a specialist for management.…”