Activation of Stratification Strategies and Results of the interventions on frail patients of Healthcare Services (ASSEHS) DG Sanco Project No. 2013 12 04

To face the challenge of active and healthy ageing (AHA), European Health Systems and services should move towards proactive, anticipatory and integrated care. Health care systems thus need to personalize services, put patients at the centre of care and provide services using the adequate resources. Population health risk management is emphasized through the use of tools to stratify people with chronic diseases according to their risk. Effective screening of frailty is vital for optimizing the care of frail populations at risk. The Activation of Stratification Strategies and Results of the interventions on frail patients of Healthcare Services (ASSEHS) EU project (N° 2013 12 04) is an international effort whose aim is to bring together stratification-related professionals from Health Services, Academia and Research in the EU in order to (i) study current existing health risk stratification strategies and tools, (ii) spread their use and application on frail elderly patients, (iii) minimize deterioration of conditions and/or (iv) prevent emergency or hospital admissions. The analysis of Risk Stratification in different Health Systems will generate conclusions and risk stratification solutions, which will be transferable to a variety of regions in the future. ASSEHS is in line with Area 4 of the B3 Action Plan of the European Innovation Partnership on Active and Healthy Ageing (EIP on AHA).     

A new philosophy for schizophrenia care

INTRODUCTION: Patients with psychotic illness are frequently dissatisfied with psychiatric services although it is unclear whether this can be explained as being due to the mental disorder itself, or to the lower quality of care received by this group of patients. We explored this issue by comparing service satisfaction from different user perspectives: patients and key relatives. METHOD: The satisfaction and needs of 52 patients with schizophrenia and 66 of their relatives were assessed using the Verona Service Satisfaction Scale (VSSS). RESULTS: Patients were generally more satisfied with services than relatives, but there was a high degree of consistency between the groups regarding the aspects of the service which they were most, and least, satisfied with. CONCLUSION: Patient satisfaction surveys can be used as reliable indicators of service quality and can highlight specific strengths and shortcomings in mental health service provision. Such surveys can be very useful to help improve the quality of care for patients and their relatives.     

Patient distribution in a mass casualty event of an airplane crash

Introduction

Difficulties have been reported in the patient distribution during Mass Casualty Incidents. In this study we analysed the regional patient distribution protocol (PDP) and the actual patient distribution after the 2009 Turkish Airlines crash near Amsterdam.

Methods

Analysis of the patient distribution of 126 surviving casualties of the crash by collecting data on medical treatment capacity, number of patients received per hospital, triage classification, Injury Severity Score (ISS), secondary transfers, distance from the crash site, and the critical mortality rate.

Results

The PDP holds ambiguous definitions of medical treatment capacity and was not followed. There were 14 receiving hospitals (distance from crash: 5.8–53.5 km); four hospitals received 133–213% of their treatment capacity, and 5 hospitals received 1 patient. Three hospitals within 20 km of the crash did not receive any casualties. Level I trauma centres received 89% of the ‘critical’ casualties and 92% of the casualties with ISS ≥ 16. Only 3 casualties were secondarily transferred, and no casualties died in, or on the way to hospital (critical mortality rate = 0%).

Conclusion

Patient distribution worked out well after the crash as secondary transfers were low and critical mortality rate was zero. However, the regional PDP was not followed in this MCI and casualties were unevenly distributed among hospitals. The PDP is indistinctive, and should be updated in cooperation between Emergency Services, surrounding hospitals, and Schiphol International Airport as a high risk area.