Comparison of the history obtained by patient-completed questionnaires with doctors’ standard notes for patients with acute abdominal pain

Saravanan, Balakrishnan; Muhammad, R; Geach, Rebecca; Jenkinson, Lloyd R.

doi:10.1136/pgmj.2007.066902

Cited by 7 publications

(7 citation statements)

References 6 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This has also been reported in studies done in high, middle and lowincome countries. Studies in the US, Wales, and the UK have shown that medical records have poorly documented general symptoms, gynaecological history, treatment side effects, smoking history and drug allergies [16,22,23]. Furthermore, the confidential enquiries to maternal deaths in the UK have also been reported to face challenges in obtaining medical record and short reports, especially from general practitioners [24].…”

Section: Comprehensiveness Of the Narrative Summaries And Action Plansmentioning

confidence: 99%

Maternal death surveillance and response in Tanzania: comprehensiveness of narrative summaries and action points from maternal death reviews

Azzoug

Pembe

Massawe

et al. 2021

BMC Health Serv Res

View full text Add to dashboard Cite

Background Maternal deaths reviews are proposed as one strategy to address high maternal mortality in low and middle-income countries, including Tanzania. Review of maternal deaths relies on comprehensive documentation of medical records that can reveal the sequence of events leading to death. The World Health Organization’s and the Tanzanian Maternal Death and Surveillance (MDSR) system propose the use of narrative summaries during maternal death reviews for discussing the case to categorize causes of death, identify gaps in care and recommend action plans to prevent deaths. Suggested action plans are recommended to be Specific, Measurable, Attainable, Relevant and Time bound (SMART). To identify gaps in documenting information and developing recommendations, comprehensiveness of written narrative summaries and action plans were assessed. Methods A total of 76 facility maternal deaths that occurred in two regions in Southern Tanzania in 2018 were included for analysis. Using a prepared checklist from Tanzania 2015 MDSR guideline, we assessed comprehensiveness by presence or absence of items in four domains, each with several attributes. These were socio-demographic characteristics, antenatal care, referral information and events that occurred after admission. Less than 75% completeness of attributes in all domains was considered poor while 95% and above were good/comprehensive. Action plans were assessed by application of SMART criteria and according to the place of planned implementation (community, facility or higher level of health system). Results Almost half of narrative summaries (49%) scored poor, and only1% scored good/comprehensive. Summaries missed key information such as demographic characteristics, time between diagnosis of complication and commencing treatment (65%), investigation results (47%), summary of case evolution (51%) and referral information (47%). A total of 285 action points were analysed. Most action points, 242(85%), recommended strategies to be implemented at health facilities and were mostly about service delivery, 120(42%). Only 42% (32/76) of the action points were deemed to be SMART. Conclusions Abstraction of information to prepare narrative summaries used in the MDSR system is inadequately done. Most recommendations were unspecific with a focus on improving quality of care in health facilities.

show abstract

Section: Comprehensiveness Of the Narrative Summaries And Action Plansmentioning

confidence: 99%

Maternal death surveillance and response in Tanzania: comprehensiveness of narrative summaries and action points from maternal death reviews

Azzoug

Pembe

Massawe

et al. 2021

BMC Health Serv Res

View full text Add to dashboard Cite

show abstract

“…This is true in high, middle and low income countries. Studies in the US and Wales, UK have shown that medical les have poorly documented general symptoms, gynaecological history, treatment side effects, smoking history and drug allergies (16,22,23). Furthermore the con dential enquiries to maternal deaths in the UK have also been reported to face challenges obtaining medical record and short reports especially from General Practitioners (24).…”

Section: Comprehensiveness Of the Narrative Summaries And Action Plansmentioning

confidence: 99%

Maternal Death Surveillance and Response in Tanzania: Comprehensiveness of narrative summaries and action points from maternal death reviews

Azzoug

Pembe

Massawe

et al. 2020

Preprint

View full text Add to dashboard Cite

Background Maternal deaths in Tanzania and other low and middle income countries occur both in and outside health facilities. Review of maternal deaths relies on comprehensive documentation of medical records that can reveal sequence of events leading to death. The World Health Organization’s and the Tanzanian Maternal Death and Surveillance (MDSR) system propose the use of narrative summaries during maternal death reviews for discussing the case to categorize causes of death, identify gaps in care and recommend action plans to prevent deaths. Suggested action plans are recommended to be Specific, Measurable, Attainable, Relevant and Time bound (SMART). To identify gaps in documenting information and developing recommendations, comprehensiveness of written narrative summaries and action plans were assessed. Methods A total of 76 facility maternal deaths that occurred in two regions in Southern Tanzania in 2018 were included for analysis. We assessed the comprehensiveness of summaries and action plans using a prepared checklist from Tanzania MDSR guideline of 2015. Presence or absence of items in four domains each with several attributes was recorded. These were socio-demographic characteristics, antenatal care, referral information and events that occurred after admission. Less than 75% completeness of attributes in all domains was considered poor while 95% and above was good/comprehensive. Action plans were assessed by application of SMART criteria and according to place of planned implementation (community, facility or higher level of health system).Results Almost half of narrative summaries (49%) scored poor, and only 1% scored good/comprehensive. Summaries missed key information such as demographic characteristics, time between diagnosis of complication and commencing treatment (65%), investigation results (47%), summary of case evolution (51%) and referral information (47%). A total of 285 action points were analysed. Most action points 242(85%) recommended strategies to be implemented at health facilities and they were mostly 42(42%) on service delivery. Only 42% (32/76) of the action points were deemed to be SMART.Conclusions Abstraction of information to prepare narrative summaries used in MDSR system is inadequately done. Action plans in MDSR system are mostly recommended to sub standard care in health facilities but are not specific on the issues to be addressed.

show abstract

“…This study con rms that MDSR systems are constrained by poorly prepared narrative summaries lacking important information. Studies in the US and Wales, UK have shown that medical les have poorly documented general symptoms, gynaecological history, treatment side effects, smoking history and drug allergies (16,22,23). This has direct negative impact on the comprehensiveness of summaries abstracted from such documentation.…”

Section: Comprehensiveness Of the Narrative Summaries And Action Plansmentioning

confidence: 99%

Maternal Death Surveillance and Response in Tanzania: Comprehensiveness of Maternal Deaths Narrative Summaries and Action Points from Death Reviews

Azzoug¹,

Pembe²,

Massawe³

et al. 2020

Preprint

View full text Add to dashboard Cite

BackgroundReview of maternal deaths relies on comprehensive documentation of medical records that can reveal sequence of events that led to death. Maternal Death and Surveillance (MDSR) system recommends the use of narrative summaries during maternal death reviews to discuss the case and categorize medical causes of death, identify gaps in care and recommend action plans to prevent deaths. Suggested action plans are recommended to be Specific, Measurable, Attainable, Relevant and Time bound (SMART). To identify gaps in documenting information and planning recommendations, comprehensiveness of written narrative summaries and adequacy of action plans according the MDSR guideline were assessed. MethodsA total of 76 facility maternal deaths that occurred in two regions in Southern Tanzania in 2018 were included for analysis. We assessed the comprehensiveness of narrative summaries and action plans using a prepared checklist from MDSR guideline of 2015. Presence or absence of items in four domains each with several attributes was recorded on the checklist. The domains were socio-demographic characteristics, antenatal care, referral information and events that occurred after admission. Less than 75% completeness of attributes in all domains was considered poor while >94% was good/comprehensive. Action plans were assessed by application of SMART criteria and according to place of planned implementation (community, facility or higher level of health system). Results Two-thirds of summaries (66%) scored poor, and none were scored as good/comprehensive. Summaries missed key information such as demographic characteristics, information of events that occurred in community (16%), time between diagnosis of complication and commencing treatment (65%), investigation results (47%), summary of case evolution (51%) and referral information (47%). A total of 285 action plans were analysed. Most action plans 242(85%) were allocated to health facilities for implementation and they were mostly 42(42%) on service delivery. Only 42% (32/76) of the action plans were deemed to be SMART.ConclusionsAbstraction of information to prepare narrative summaries used in MDSR system is inadequately done. Action plans and recommendations in MDSR system are mostly for facility sub standards of care and are not specific on the issues to be addressed.

show abstract

Comparison of the history obtained by patient-completed questionnaires with doctors’ standard notes for patients with acute abdominal pain

Abstract: Patient-completed questionnaires can be used to obtain a more accurate history than junior doctors for most patients admitted with acute abdominal pain.

Cited by 7 publications

References 6 publications

Maternal death surveillance and response in Tanzania: comprehensiveness of narrative summaries and action points from maternal death reviews

Maternal death surveillance and response in Tanzania: comprehensiveness of narrative summaries and action points from maternal death reviews

Maternal Death Surveillance and Response in Tanzania: Comprehensiveness of narrative summaries and action points from maternal death reviews

Maternal Death Surveillance and Response in Tanzania: Comprehensiveness of Maternal Deaths Narrative Summaries and Action Points from Death Reviews

Contact Info

Product

Resources

About