Source:https://www.pennmedicine.org/news/news-releases/2018/november/yelp-reviews-reveal-strengths-and-weaknesses-of-emergency-departments-and-urgent-care-clinics Reviewed by James Ives, M.Psych. (Editor)Nov 12 2018Yelp reviews reveal that emergency departments are viewed as being higher quality but lacking in service as compared to urgent care centers, which patients rate the opposite, according to a new study from researchers in the Perelman School of Medicine at the University of Pennsylvania. The study results, published this month in the Annals of Emergency Medicine, provide a unique opportunity for researchers and clinicians to learn from online reviews, which provide a raw narrative from consumers.”Today’s world is very digital, and it’s very common for consumers to rate a restaurant, hotel or service online, a practice that is spilling over into health care,” said the study’s lead author, Anish Agarwal, MD, a National Clinician Scholars fellow and Emergency Medicine physician at Penn Medicine. “As an emergency department physician, patients often tell me that the internet is the first place they go for information about medical conditions and to research providers. Health systems and clinicians can learn a lot about the communities they treat and how people experience the services they provide by looking to online ratings and reviews.”In this new study, researchers, with the help of an automated system, analyzed high (five-star) and low (one-star) Yelp reviews for both emergency departments and urgent care centers, two venues that patients can select from when in need of acute care.Researchers identified key themes in the five-star reviews of emergency departments, including bedside manner, treatment of family members, and access to care on nights and weekends. Urgent care centers were unique in receiving five-star reviews more often for factors including ease of refilling prescriptions and being positively recommended by others.On the other side, emergency departments received negative remarks for speed of care, while urgent care centers received one-star reviews as a result of poor reception experiences and patients lacking confidence in the care received.”We are seeing more and more that patients are sharing their experiences online, and they’re looking to social media platforms and online communities to help inform their decision-making,” said Kevin B. Mahoney, executive vice president and chief administrative officer of the University of Pennsylvania Health System. “Within these review and rating websites lies a trove of decision-making data that we can and should be culling through to help inform how care is delivered, and what matters most to our patients in emergency situations.”Related StoriesIt is okay for women with lupus to get pregnant with proper care, says new studyAMSBIO offers new, best-in-class CAR-T cell range for research and immunotherapyOlympus Europe and Cytosurge join hands to accelerate drug development, single cell researchUrgent care centers have proliferated widely across the country in the past 15 years. Between 2007 and 2016, visits increased by more than 1,700 percent. But while emergency departments have established surveys for patients and their families to report their experiences, there is not a clear equivalent for gathering direct feedback from patients who visit urgent care centers.The study’s senior author, Raina Merchant, MD, director of the Penn Medicine Center for Digital Health and an associate professor in Emergency Medicine, believes Yelp reviews could fill a knowledge gap.”Online reviews provide a rapid way of taking the pulse of how this acute care market is emerging and what consumers look for in these settings” said Merchant. “These platforms can also help us identify new focus areas, in an effort to provide better, more efficient care to patients based on their expressed needs.”The researchers analyzed more than 100,000 Yelp reviews, posted between 2005 and 2017–in the midst of the urgent care boom–tied to 1,566 emergency departments and 5,601 from urgent care centers. During the study period, an average of one new review for an emergency department or an urgent care center appeared every hour of every day.The reviews fell largely on one end of the spectrum or the other: five stars or one star. Roughly 47 percent of emergency department and 30 percent of urgent care center reviews fell in the one-star category. The disproportionate amount of negative reviews for acute care facilities, compared to other entities reviewed online, like hotels or restaurants, could be a result of what is at stake for the consumer.”If a restaurant provides you with a quick meal exactly as advertised, they meet your expectations,” Merchant said. “With healthcare, things are different. People are often critically ill, the outcomes are uncertain, and the wait can be long–which are all things that sometimes can’t be controlled.”The research team found that each type of facility received similar five-star reviews for comfort, cleanliness of facilities, pediatric care, and professionalism. One-star reviews for poor phone experiences, long wait times, billing difficulties, and pain management were tied to both emergency departments and urgent care centers.Moving forward, the researchers hope to find more nontraditional sources to provide clues about patient experiences and use them to enhance care quality.
Reviewed by Alina Shrourou, B.Sc. (Editor)Nov 30 2018Bottom Line: Patients from the poorest neighborhoods who had cardiac arrest had longer total ambulance times than those from the wealthiest neighborhoods.Why The Research Is Interesting: Emergency medical services (EMS) provide critical care before patients reach the hospital and differences in ambulance times may contribute to disparities in patient outcomes.Related StoriesMore patients may suffer cardiac arrests than previously estimatedStudy analyzes high capacity of A. baumannii to persist on various surfacesHome-based support network helps stroke patients adjust after hospital dischargeWhat and When: National data from 46 states on 63,600 patients who had cardiac arrest and didn’t die on scene and were transported to a hospitalWhat (Study Measures and Outcomes): Four time measures were examined (response time, on-scene time, transport time and total EMS time) and compared with EMS response time benchmarks for responding to cardiac arrest calls.How (Study Design): This was an observational study. Researchers weren’t intervening for purposes of the study and cannot control all the natural differences that could explain the study findings.Authors: Renee Y. Hsia, M.D., M.Sc., University of California, San Francisco, and coauthorsStudy Limitations: The registry analyzed for this study wasn’t of individual patients so multiple reports associated with the same patient exist; other explanations beyond the variables assessed in this study may have contributed to time disparities; and the findings may not be generalized to other types of time-sensitive EMS calls. Source:https://media.jamanetwork.com/news-item/do-lower-income-neighborhoods-experience-longer-ambulance-times/ read more
Reviewed by Kate Anderton, B.Sc. (Editor)Jun 26 2019With summer in full swing, many people are cooling off in swimming pools. However, some of the substances that are made when chlorine in the water reacts with compounds in human sweat, urine or dirt aren’t so refreshing. Now, researchers have compared the effectiveness of different water treatment processes in mitigating these so-called disinfection byproducts (DBPs). They report their results in ACS’ journal Environmental Science & Technology.Chlorine is usually added to pool water to kill harmful microbes. However, this disinfectant can react with substances in the pool water — many of which are introduced by swimmers themselves — to form DBPs, which can irritate the eyes, skin and lungs. Most pool systems continuously recirculate water through various treatment steps to both disinfect the water and reduce DBPs and their precursors. But because of the difficulty of comparing swimming pools with different conditions, such as number of swimmers, chlorine dosing or filling-water quality, scientists don’t currently know which strategy is the best. So, Bertram Skibinski, Wolfgang Uhl and colleagues wanted to compare several water treatment strategies under the controlled and reproducible conditions of a pilot-scale swimming pool system.Related StoriesSummertime safety guidelines for childrenComplement system shown to remove dead cells in retinitis pigmentosa, contradicting previous researchCurved shape of bacteria can make it easier to find foodThe researchers continuously added compounds to their model swimming pool that simulated dirt and body fluids and added chlorine according to regulations for full-scale pools. Then, they treated the water with one of seven water treatment strategies. They found that the treatment using coagulation and sand filtration combined with granular activated carbon filtration was the most effective at lowering DBP concentrations. But even this treatment did not completely remove the contaminants because new DBPs were made more quickly than the old ones could be removed. When UV irradiation was used as a treatment step, the levels of some DBPs increased because the UV light elevated the reactivity of organic matter toward chlorine. New strategies need to be explored to more effectively remove DBPs and prevent new ones from forming, the researchers say. Source:American Chemical SocietyJournal reference:Skibinski, B. et al. (2019) Impact of Different Combinations of Water Treatment Processes on the Concentration of Disinfection Byproducts and Their Precursors in Swimming Pool Water. Environmental Science & Technology. doi.org/10.1021/acs.est.9b00491. read more
SHARE COMMENT Published on Toracabs Technology Services has announced the launch of Tora Cabs, a technology platform for cab hiring starting with Hyderabad.Conceived in 2017 and launched in June 2019, Tora is a joint venture with a Korean partner headquartered in New Delhi.SB Shin, Director, Toracabs Technology Services said, “Through this joint venture partnership we expect to benefit a larger number of people. It was important to partner with a brand that is based on values and that would give an edge to both the driver and the customer.”Kavita Bhaskaran Ravi, Director, Marketing & Public Policy, Toracabs Technology Services said, “Tora is based on the vision of bringing convenience and benefits to the customers and drivers. It has been created with a philosophy of “No Commission” and ‘No Surge.”“With TORA we plan to change the way you look at the ride hailing industry,” she said.The company plans to bring about a paradigm shift in this sector with its business model built on the ethos of bringing fair play and technology innovation for the larger public.Business modelTora is focussed on a sustainable model based on taking zero commission from drivers. Drivers will only be charged pay per use fees starting with a nominal Rs 199 per day, 199 x6 for 7 days, and 199 x 25 for a month. This gives the driver the option of paying for only the days he uses. The ‘No commission’ model ensures better earnings.Since its launch on June 12, Tora has already on board 1,500 plus drivers .Tora technology aims to make it a transparent business with its app for both riders and drivers. Zero surge, zero commission cab service aims to make it a transparent business model for both riders and drivers new service Hyderabad Cabs COMMENTS SHARE SHARE EMAIL June 27, 2019 read more
May 30, 2019 politics COMMENT Published on SHARE Prasad is a key face of the party nationally and will be a vital cog in the wheels of the new Cabinet Ravi Shankar Prasad, who emerged victorious against the Congress’ Shatrughan Sinha in a high-stakes battle for the Patna Sahib constituency, is making his Lok Sabha debut. Prasad, who started out as a volunteer of the ABVP, the students’ wing of the RSS, played an active role in protests against Emergency. He became a member of the national executive committee of the BJP in 1995 and was elected to the Rajya Sabha for the first time in 2000. Prasad has held Minister of State portfolios in the Atal Behari Vajpayee-led government and was appointed the BJP’s national spokesperson in 2005. As the Electronics and IT Minister in the previous Modi-led government, Prasad played a leading role in boosting the manufacturing of electronic products in India, with major players such as Samsung and Xiaomi widening their presence. Under the Digital India initiative, he also focused on setting up Common Service Centres that helped people avail digital services from the government. Prasad also served as Law Minister and handled the Triple Talaq issue. Prasad is a key face of the party nationally and will be a vital cog in the wheels of the new Cabinet. ministers (government) Elections 2019 national politics 0 SHARE SHARE EMAIL COMMENTS read more