Missed Opportunities: Evolution of Patients Leaving without Being Seen or against Medical Advice during a Six-Year Period in a Swiss Tertiary Hospital Emergency Department.

Aim. The study aimed at describing the evolution over a 6-year period of patients leaving the emergency department (ED) before being seen ("left without being seen" or LWBS) or against medical advice ("left against medical advice" or LAMA) and at describing their characteristics. Methods. A retrospective database analysis of all adult patients who are admitted to the ED, between 2005 and 2010, and who left before being evaluated or against medical advice, in a tertiary university hospital. Results. During the study period, among the 307,716 patients who were registered in the ED, 1,157 LWBS (0.4%) and 1,853 LAMA (0.9%) patients were identified. These proportions remained stable over the period. The patients had an average age of 38.5 ± 15.9 years for LWBS and 41.9 ± 17.4 years for LAMA. The median time spent in the ED before leaving was 102.4 minutes for the LWBS patients and 226 minutes for LAMA patients. The most frequent reason for LAMA was related to the excessive length of stay. Conclusion. The rates of LWBS and LAMA patients were low and remained stable. The patients shared similar characteristics and reasons for leaving were largely related to the length of stay or waiting time.

Public Service Agreement - Health Sector Progress Report and Savings - May 2011

Public Service Agreement – Health Sector Progress Report and Savings – May 2011 Click here to download PDF 4.69MB

Public Service Agreement - Health Sector Progress Report - October 2011

Public Service Agreement – Health Sector Progress Report – October 2011 Click here to download PDF 7.66MB

Public Service Agreement 2010-2014 - Health Sector Action Plan 2012

This revised Action Plan is designed to support the delivery of the HSEâ?Ts 2012 National Service Plan by facilitating the fast-tracking of measures required to deliver essential health and personal social services across the country within the context of further reductions in funding and staff numbers. The implementation of the National Service Plan, approved by the Minister for Health on 13 January 2012, represents a major challenge to the health services and comes at a time of major reform of the public health system.   Click here to download PDF 161kb

Public Service Agreement - Revised Health Sector Action Plan - December 2012

The health service has been at the forefront in delivering significant change under the PSA. The substantial contribution already made by health service staff, especially during the period of concentrated retirements up to February 2012, is acknowledged and much appreciated by management. These changes are being achieved in what is a complex working environment with increasing demands, (500,000 increase in medical card holders between 2007 and 2012) and a growing and ageing population, within a public health service which is undergoing unprecedented organisational change and reform, accompanied by a reducing workforce. Public Service Agreement – Revised Health Sector Action Plan- December 2012 savings report Click here to download PDF 51kb

Public Service Agreement - Health Sector second annual progress and savings report

Department cover letters PDF 839kb Main health sector progress report PDF 11.1mb Traffic light document PDF 39kb Savings template PDF 268kb

Public Service Agreement Health Sector 3rd Annual Progress Report 1st April to 31st December 2012

Public Service Agreement Health Sector 3rd Annual Progress Report 1st April to 31st December 2012 Click here to download PDF 1MB

Health Sector Children First Strategic Implementation Plan

Health Sector Children First Strategic Implementation Plan Children First: National Guidance for the Protection and Welfare of Children (2011) (referred to as Children First hereafter), is intended to assist people in identifying and reporting child abuse and neglect and deal effectively with concerns. It emphasises that the needs of children and families must be at the centre of child protection and welfare services, and that the welfare of children is of paramount importance. Click here to download PDF 73KB

Surgical outcomes following repeat non-penetrating glaucoma filtration surgery at a tertiary referral centre

Purpose:To determine the surgical outcomes of patients undergoing repeat deep sclerectomies with collagen implant (DSCI) at a tertiary referral centre. Methods:The medical notes of 208 patients undergoing multiple DSCI were reviewed. Those undergoing repeat DSCI were identified and post operative data for each DSCI were analysed. Group A: the first DSCI; group B: second DSCI; group C: third DSCI. Results:Mean age was 66.8 ±13.0 years. At 12 months, percentage of mean IOP reduction in groups were 18%, 24% and 17% respectively. Mean interval to starting glaucoma medications, re-operation, mitomycin injection and goniopuncture all decreased as the number of operations increased. There was a significant reduction in complete success rates between groups A and B and groups B and C. Few minor complications were observed in all 3 groups. Conclusions:Despite the possibility of bleb independent outflow pathways in patients undergoing non-penetrating surgery, there are significantly reduced success rates in eyes undergoing repeat DSCI. This has important implications for the choice of subsequent operations in patients who have failed non-penetrating filtration surgery.

Commissioning for equity. A briefing on inequalities in access to revascularisation in the NHS and in the independent sector among London residents

This briefing describes inequalities in access to revascularisation using data from both the NHS and the independent sector.

Commissioning for equity. Inequalities in access to revascularisation in the NHS and in the independent sector. A technical report

This document describes the methodology for examining inequalities in access to revascularisation in the NHS and in the independent sector. It is a technical report.

Usabilitat d'una aplicació informàtica dins el sector del programari mèdic

L'objectiu principal d'aquest treball de final de carrera és estudiar la usabilitat en el programari en general i específicament quina relació té amb el programari mèdic.

Regulatory Reform of the International Education Sector and the Student Immigration Regime

Ireland has a strong reputation for delivery of high-quality education services both to our own citizens and those who come here from abroad. A degree from an Irish university, Institute of Technology or high-quality private sector provider is an indicator of significant educational achievement, highly valued by our students and employers alike. Ireland is also a specialist in high-quality English Language tuition. Many thousands of students from the EU and around the world come to Ireland for full-time or short-term programmes.

The Forum on Patronage and Pluralism in the Primary Sector - Report of the Forum's Advisory Group

The fact that 96 percent of primary schools in Ireland are under denominational patronage is unique among developed countries. The reasons for this are deeply rooted in history and in the belief system of the population. With the establishment of the National (Primary) School system in 1831 the State provided financial support to local patrons for primary school provision, on the condition that patrons observed the regulations of the newly established Commissioners of National Education. While the State favoured applications from patrons of mixed denominations, what evolved, in practice, was that the great majority of schools came under the patronage of individual clergymen of different denominations.

Substance Misuse Among People Over 55 - Perspectives from the Community and Voluntary sector in Belfast

The Belfast Health Development Unit (BHDU) was established as a Ministerial priority in March 2010, co-locating staff from The Public Health Agency (PHA), Belfast Health and Social Care Trust (BHSCT) and Belfast City Council (BCC). One of the strategic priorities for the BHDU is: an integrated approach to planning and delivery of services for older people in the city.The PHA and the BHDU had identified a need to examine the extent of substance misuse issues within the older population of the city of Belfast and to explore early intervention programmes targeting this population. It is envisioned that this piece of work will inform and support the Belfast Healthy Ageing Strategic Partnership on older people and its multi-sectoral action plan and will influence the work and priorities of the Belfast Strategic Partnership and its constituent stakeholders in taking drug and alcohol work forward in Belfast.The aim of this research was to review knowledge, awareness and evidence of the impact of substance misuse on the older population (aged 55+) and to review good practice in reducing substance related harm within this population which has been done by undertaking a review of available research, data and information sources. However, the main focus of the research involved consulting with a broad range of community and voluntary sector organisations working in the Belfast area to assess their views and perceptions of the prevalence and extent of substance misuse within the older population and the services currently in place to address this issue.�