Case Management Team Research Articles

"It's Pure Chaos Every Day": COVID-19 and the work of Canadian federal institutional parole officers.

As the Canadian federal correctional system grappled with the onset of the COVID-19 pandemic, institutional parole officers, who play a central role in prisoners’ case management team, remained essential service providers. Working in uncertain circumstances, these correctional workers navigated new and rapidly changing protocols and risks, while attempting to continue to provide support to those on their caseloads. Based on semi-structured interviews with 96 institutional parole officers, conducted after Canada’s “first wave” of COVID-19 infections, we analyze three ways in which their work was impacted by the pandemic: shifting workloads, routines, and responsibilities; increased workloads due to decarceration (i.e., efforts to reduce the number of incarcerated individuals); and the navigation of new forms of risk and uncertainty. This study advances the understanding of stress and risk in probation and parole work and presents recommendations to ameliorate the occupational stresses experienced by correctional workers during and beyond COVID-19.

Experiences of case and contact management teams during the COVID-19 pandemic response in Ontario

Case and contact management (CCM) teams play a vital role in the COVID-19 pandemic response. This study aims to understand the experiences of CCM team members during the COVID-19 pandemic to identify areas of improvement for future crises. A mixed-methods, cross-sectional online survey was conducted from November 2020 to March 2021. There were a total of 49 relevant survey responses. Participants were CCM team members responding to the pandemic in Ontario. Frequency tabulations were used to analyze closed-ended survey responses, and both a conventional content analysis and thematic analysis were conducted on the open-ended responses. Study results revealed that inadequate planning and preparedness, poor communication, high workloads, and stress levels of CCM team members were notable areas of concern. These matters ultimately affected the well-being of CCM team members and acted as barriers to completing CCM work. It is imperative that adequate staffing and accessibility to mental health support from employers are improved in future times of crisis to ensure that CCM teams are able to meet the demands of their work. Further studies should be conducted to examine the experiences of CCM team members as well as barriers and facilitators to completing CCM work.

The Diagnosis of Brain Death

Organ transplantation is impossible without donation which is performed both intra vitam and posthumously. Each case of multi-organ collection provides help to 4 to 6 patients. We believe that presentation of modern algorithms for diagnosing brain death is quite feasible, and such information can be useful not only for anesthesiologists, but also for doctors of other specialties. This paper presents materials related to organ donation. Diagnostic criteria for human brain death, as well as the procedure for ascertaining human brain death and the actions of doctors of healthcare institutions in relation to persons who are in these institutions and who have clinical indications for the diagnosis of brain death, are determined by "The procedure for cancellation of active measures to maintain the patient's life…". Active measures (ventilation, infusion therapy and vasopressor support, etc.) to support the patient's life are cancelled after the patient's brain death is ascertained, except for cases where the deceased person is considered a potential donor. Verification of the human brain death is carried out by the case management team of the healthcare institution involving, if necessary, members of consultative and diagnostic mobile team, specialists of other healthcare institutions. The head of the healthcare institution is responsible for timely and proper engagement and work of the case management team. The responsible person determines the membership of the case management team by making an appropriate entry in the case record and is responsible for its work.
 An anesthesiologist and a neurologist (neurosurgeon) who have at least 5 years of practical experience in the specialty are engaged in the case management team to ascertain brain death in persons over 18 years of age.
 Physicians involved in the removal of human anatomical materials and transplantation thereof, as well as transplant coordinator, may not be included in the case management team.

Cops, Clinicians, or Both? Collaborative Approaches to Responding to Behavioral Health Emergencies.

How a community responds to behavioral health emergencies is both a public health issue and social justice issue. Individuals experiencing a behavioral health crisis often receive inadequate care in emergency departments (EDs), boarding for hours or days while waiting for treatment. Such crises also account for a quarter of police shootings and >2 million jail bookings per year. Racism and implicit bias magnify these problems for people of color. Growing support for reform provides an unprecedented opportunity for meaningful change, but solutions to this complex issue will require comprehensive systemic approaches. As communities grapple with behavioral health emergencies, the question is not just whether law enforcement should respond to behavioral health emergencies but how to reduce unnecessary law enforcement contact and, if law enforcement is responding, when, how, and with what support. This policy article reviews best practices for law enforcement crisis responses, outlines the components of a comprehensive continuum-of-crisis care model that provides alternatives to law enforcement involvement and ED use, and offers strategies for collaboration and alignment between law enforcement and clinicians toward common goals. Finally, policy considerations regarding stakeholder engagement, financing, data management, legal statutes, and health equity are presented to assist communities interested in taking steps to build these needed solutions.

Personal experience as COVID-19 patient and management in the National Referral Hospital, Kampala, Uganda

We were immediately admitted in the National Mulago Referral Hospital, Kampala in the High Dependent Unit (HDU) ward in the early morning (12 am) of 29th October, 2020 and discharged on 7th November, 2020. At the time of our admission in late October despite of the aggressive and rapid scientific search for COVID19 cure, no drug had been found to be effective against COVID19. However, Case Management Team under Ministry of Health (MoH) had approved treatment guidelines especially for severe cases that included Hydroxychloroquine, Azithromycin, Dexamethasone, Paracetamol and Vitamin C and other support measures that varied from one patient to another.

Arranging Hospice Care from the Emergency Department: A Single Center Retrospective Study

BackgroundArranging hospice services from the Emergency Department (ED) can be difficult due to physician discomfort, time constraints, and the intensity of care coordination needed. We report patient and visit characteristics associated with successful transition from the ED directly to hospice. MethodsSetting: Academic ED with 82,000 annual visits. Population: ED patients with a referral to hospice order placed during the ED visit from January 2014-December 2018. Charts were abstracted by trained, non-blinded personnel. Primary goal was to evaluate patient and visit factors associated with requiring admission for hospice transition. ResultsElectronic Health Record inquiry yielded 113 patients, 93 of which met inclusion criteria. Patients were aged 65.8 years (range 32-92), 54% were female, and 78% were white, non-hispanic. The majority had cancer (78%, n = d72) and were on public insurance (60%, n = 56). Half (55%, n = 51) were full code upon arrival. Average ED length of stay was 4.6 ± 2.6 hours. Discharge from the ED to hospice was successful for 38% (n = 35), a few (n = 5) were dispositioned to an ED observation unit, and 57% (n = 53) were admitted. Only 10 (11%) required an inpatient length of stay longer than an observation visit (2 days). Case management and social work team arranged for transportation (54.8%, n = 51), hospital beds (16.1%, n = 16), respiratory equipment (18.3%, n = 17), facility placement (33.3%, n = 31), and home health aides (29.0%, n = 27). ConclusionTransitioning patients to hospice care from the ED is possible within a typical ED length of stay with assistance from a case manager/social work team.

Supporting the Mental Health of Primary Care Nurses and Staff through the Pandemic and Beyond

As a clinical nurse specialist, I provide leadership and strategy for our primary care program where I lead clinical initiatives and develop practice tools and guidelines across our clinics. My portfolio encompasses five clinics, one perinatal program, an opioid agonist therapy (OAT) clinic and an intensive case management team, and in the past year I supported several teams that focus on COVID-19 testing and isolation support. Our clinics specialize in serving people who experience significant economic and social marginalization and those who are not well served by traditional health services. Our nurses, in particular, juggle many roles: providing both outreach- and clinic-based care and supporting our injectable OAT program, youth clinic and our transgender specialty care program. Our work has become increasingly complex as our clients navigate survival with competing syndemics - the opioid crisis, COVID-19, a Shigella outbreak and an ongoing housing crisis - among the many significant structural factors that impact our clients' health.

Qualitative evaluation of primary care providers’ experiences caring for frequent users of the emergency department

ObjectivesMany interventions have been developed over the years to offer frequent users of the emergency department (FUEDs) better access to quality coordinated healthcare. Despite recognising the role primary care physicians...

856-P: Long-Term Benefits of Multicomponent Integrated Care Program Participation on Diabetes Care Goals: The DIABEMPIC Program

Diabetes burden is greater in low- middle-income countries, where large gaps exist in achieving diabetes care goals. We examined a quality initiative multicomponent integrated care (MIC) program (DIABEMPIC, DIABetes EMPowerment and Improvement of Care) on diabetes care goals in adults with type 2 diabetes (T2D) implemented in a public primary care specialized diabetes clinic in Mexico City/Iztapalapa. DIABEMPIC is a 5-month empowerment-based program that includes an interdisciplinary case management team, diabetes self-management education, shared medical appointments, a patient-centered approach, and audit and feedback. At the end of the program patients continue routine care in public primary care units. We report the effect of the intervention on diabetes care goals at the end of the program and 18 months after the initial recruitment (long-term evaluation). Results: 704 patients with T2D completed the program, and 182 already have a long-term evaluation. The mean (SD) age of this subgroup was 57 (10.9) years, 67% female, 61% had elementary or less education, 68% had medium-low or lower socioeconomic status, mean diabetes duration was 13 (8) years, and mean A1c was 9.5% (2.2). After the program (n=182) systolic and diastolic blood pressure (-11, -4 mmHg respectively), A1c (-2.6%), and non-HDL cholesterol (-29 mg/dl) decreased significantly (p<0.0001). Clinical benefits persisted in long-term evaluation in systolic and diastolic blood pressure (-9, -3 mmHg respectively, p<0.0001), A1c (-1.4%, p<0.0001), and non-HDL cholesterol (-11 mg/dl, p=0.018). Conclusions: This quality-of-care initiative had valuable short and long-term effects on diabetes care goals in a real-world setting. The long-term impact is smaller than the impact observed at the end of the intervention. This work suggests further replication of the intervention and enhances the need to improve routine follow-up in primary health units after the participation in MIC programs. Disclosure R. Silva-tinoco: None. A. Gallardo-hernández: None. J. Ochoa-moreno: None. V. Delatorre-saldaña: None. T. Cuatecontzi-xochitiotzi: None. A. Gonzalez-cantu: None. C. Castillo-galindo: None. B. Pimentel-hernández: None. M. Romero-ibarguengoitia: None. A. Núñez-rodríguez: None. F. Orozco-gutiérrez: None.

Community acceptance of COVID-19 and demystifying stigma in a severely affected population in Ghana.

We assessed the level of community acceptance of COVID-19, identified and implemented strategies to demystifying stigma in a severely affected population in Tema. We conducted a cross-sectional study to assess stigma among the Tema community, then identified and implemented interventions to demystify COVID-19 stigma. We interviewed positive cases, their contacts, contact tracers, case management team members, and community members who shared their first hand experiences and knowledge on the current pandemic. Based on the information received, we came up with ways of reducing stigma and implemented them in their community. Stigma demystified. Cases and contacts reported being avoided, discriminated against, insulted or had derogatory words used on them by family, friends, work colleagues or the community. Cases and their contacts stated that stigmatisation was fueled by the presence of COVID -19 branded vehicles and security officials at their homes or workplaces. Stakeholder engagement, education and extensive sensitisation of community members were implemented to reduce stigma. We observed deeply entrenched stigma to COVID - 19 positive patients and their contacts in the community. Health care response mechanisms such as the presence of security personnel with contact tracers and case managers and the use of COVID -19 branded vehicles fueled stigma. A multifaceted approach through the engagement of key stakeholders, training of health workers and extensive education and community sensitisation was essential in reducing stigma. The COVID-19 outbreak response and writing workshop by the Ghana Field Epidemiology and Laboratory Training Programme (G.F.E.L.T.P.) was supported with funding from President Malaria Initiative - C.D.C., and Korea International Cooperation Agency (on C.D.C. CoAg 6NU2GGH001876) through AFENET.

Outcomes and applicability of a deep learning virtual tumor board (DLVTB) in community-dwelling colorectal cancer (CRC) patients.

e18635 Background: With almost 85% of patients treated outside NCI-designated cancer centers, providing comprehensive, state-of-the-art cancer care to millions of patients in the U.S. remains a significant challenge. We aimed to combine cutting edge AI based technology of DLVTB with high value-added services to provide evidence-based care management recommendations and implementation support to the patients and physicians in the community. To further demonstrate the feasibility, reproducibility, scalability, and benefits of DLVTB, we evaluated key outcomes from incorporating DLVTB in a cohort of 35 patients with advanced colorectal adenocarcinoma (CRC). Methods: Our core-enabling technology is a deep learning based Natural Language Understanding Engine that employs (1) natural language processing for medical text digestion and structuring, (2) decision trees and multilayer perception models to produce evidence-based treatment protocols, and (3) natural language based report generation. The technology platform is combined with human support from oncology sub-specialists to deliver a comprehensive Interpretive Report with a prioritized list of recommendations for each patient. These recommendations are operationalized by a case management team to ensure care implementation and monitoring of outcomes. Results: Thirty-five patients with CRC were referred for incorporation of DLVTB into clinical practice. Median age of patients was 57 years with 68.6% males. About 88.6% of the patients were Stage IV and 82.9% were treated by community practice oncologists. Median time since diagnosis was 17 months (1-73 months). Overall, DLVTB-cohort demonstrated an increase in median Overall Survival of 12 months per patient in comparison with historical cohorts. More specifically, DLVTB recommended initial and/or additional biomarker testing for 71% of the patients with further precision oncology-guided treatment recommendation (e.g. an EGFR inhibitor) for 80% of the patients. 63% of the patients were eligible for at least one clinical trial. 58% of the trials identified were within proximity (≤50 miles) of the patient’s primary residence. Thus, DLVTB was able to identify a trial that did not require extensive travel, provided eligibility and actionability closer to the point-of-care. 14% of the DLVTB evaluated patients subsequently enrolled in the recommended clinical trial, far surpassing the national average (3%). Moreover, DLVTB recommended treatments achieved on average savings of $39,194 per patient which is 35% of the average drug cost per patient. Conclusions: Our results demonstrate the feasibility and benefits of incorporating DLVTB into clinical practice. The utilization of DLVTB as a clinical trial enrollment tool and an engine for development of pathways resulting in improved clinical outcomes, in a cost-effective, and innovative care delivery model.

Primary Care Records of Chronic-Disease Patient Adherence to Treatment.

The goal of managing adherence (AD) is to achieve better medication use by patients in order to maximize benefits and reduce risks. With the aim of improving treatment adherence by patients, we carried out a descriptive study to obtain information related to adherence management in primary care. Inclusion criteria were as follows: patients that had at least one record of any treatment adherence assessment variable. For those that had more than one recorded variable, we analyzed consistency across test results. For the comparative analysis of adherence records, patients were categorized into three groups on the basis of the healthcare unit that recorded the data: case management (CM), home care (HC), and primary care team (PCT). A total of 32,137 subjects met inclusion criteria; 79.56% of subjects were older than 65. As for the analysis of assessment records across care units, 69.73% of CM patients, 67.17% of HC patients, and 2.33% of PCT patients had adherence assessment records. CM units made a significantly greater number of records than HC units. We observed low adherence at a rate of 49.3% in the CM group, 31.91% in the HC group, and 17.58% in the PCT group. When more than one adherence variable was recorded, analysis revealed inconsistent test results or recorded variables in 9.06% of PCT cases, 14.83% of HC cases, and 20.47% of CM cases. The inconsistencies observed in records of adherence assessment and management across different care units reveal the huge variability that exists in managing and selecting a tool to assess adherence.

Effect of a Real-Time Risk Score on 30-day Readmission Reduction in Singapore

To develop a risk score for the real-time prediction of readmissions for patients using patient specific information captured in electronic medical records (EMR) in Singapore to enable the prospective identification of high-risk patients for enrolment in timely interventions. Machine-learning models were built to estimate the probability of a patient being readmitted within 30 days of discharge. EMR of 25,472 patients discharged from the medicine department at Ng Teng Fong General Hospital between January 2016 and December 2016 were extracted retrospectively for training and internal validation of the models. We developed and implemented a real-time 30-day readmission risk score generation in the EMR system, which enabled the flagging of high-risk patients to care providers in the hospital. Based on the daily high-risk patient list, the various interfaces and flow sheets in the EMR were configured according to the information needs of the various stakeholders such as the inpatient medical, nursing, case management, emergency department, and postdischarge care teams. Overall, the machine-learning models achieved good performance with area under the receiver operating characteristic ranging from 0.77 to 0.81. The models were used to proactively identify and attend to patients who are at risk of readmission before an actual readmission occurs. This approach successfully reduced the 30-day readmission rate for patients admitted to the medicine department from 11.7% in 2017 to 10.1% in 2019 (p < 0.01) after risk adjustment. Machine-learning models can be deployed in the EMR system to provide real-time forecasts for a more comprehensive outlook in the aspects of decision-making and care provision.

Home management of mild-moderate coronavirus disease-19 patients in low-resource countries: Reducing the burden on hospitals and a guide to clinical excellence

The severe acute respiratory syndrome coronavius-2 (SARS-CoV-2) pandemic since when it was reported from Wuhan, China, in December 2019 has spread dramatically and rapidly affecting all countries and territories of the world. The morbidity and mortality rates of coronavirus disease (COVID-19) continue to climb each day with over 88 million people infected and more than 2 million deaths reported worldwide. This puts health-care systems and health-care professionals/providers (HCPs) at risk. At present, the health-care systems of the poor and low resource are unable to cope with these extremely difficult circumstances. The main objective of this article is to serves as a guideline for treating patients with mild or moderate symptoms of COVID-19 at home in over to reduce the already over burden health infrastructure, especially in developing nations. With the permission of the ethical committee of the institutions COVID-19 case management team, this article reviewed protocol-based guideline aimed at infection prevention and control to protect the health worker, the patient, his relatives, and the community and also drug treatment to help prevent the progression of the disease to severe or critical. The home treatment guideline will help poor and low-resource countries cope with the increase in number of patients with COVID-19 and ameliorate the negative effects on health-care resources for such countries that are already burden by poor or limited health system infrastructure, low workforce, and inadequate expertise to cope with the rapidity with which the virus spread.

How working at NHS Test and Trace landed me a role heading my university’s COVID-19 case management team

For two days a week, I work as GP practice pharmacist. For another two days, I lecture in pharmacy practice at the University of Reading. And one day every other week, I work in a Boots community pharmacy in Wiltshire; all while having two children aged under four years. A real portfolio career! But in […]

Effect of Housing First on violence-related traumatic brain injury in adults with experiences of homelessness and mental illness: findings from the At Home/Chez Soi randomised trial, Toronto site

ObjectivesPeople experiencing homelessness have a high prevalence and incidence of traumatic brain injury (TBI) due to violence. Little is known about the effectiveness of interventions to reduce TBI in this...

Case Management Models and Continuing Care: A Literature Review across nations, settings, approaches, and assessments

Older adults accessing continuing care often have multiple chronic conditions. Research suggests that case management is a promising approach to reduce health care expenditure and improve patient outcomes. To optimize healthcare delivery, an examination of existing case management models and their effectiveness is essential. This literature review was conducted using Joanna Briggs Institute (JBI) methods to explore case management models for older adults accessing continuing care services. Searches were conducted in PubMed and CINAHL from 2010 to 2018. A total of 37 articles were included in this review. Approaches to case management are diverse with respect to composition of care providers, method of care provision, and location of care. Findings from 27 quantitative studies demonstrated that nurse-led and interdisciplinary team case management models that include home visits can effectively reduce hospital admission/readmission while lowering costs. Mixed results were found on the impact of case management on patient satisfaction, ED visits, quality of life, length of stay, self-efficacy, social integration and caregiver burden. Among 10 qualitative studies, 3 facilitators for quality case management were identified that include receiving care at home, building trusting relationships, and improving self-efficacy. Based on these findings, we conclude that nurse-led and interdisciplinary team case management can effectively reduce hospital admission of frail older adults while lowering costs, particularly within home care settings.

Serious Illness Conversations: A Case Management Quality Improvement Project.

The purpose of this project was to develop, implement, and evaluate an educational program and a serious illness (SI) protocol for a case management team of nurses and social workers to achieve the following: (1) utilize an SI protocol to identify patients with SI; (2) utilize a Serious Illness Structured Communication Guide to elicit these patients' goals and preferences for SI care; and (3) document in the electronic medical record the patients' elicited values and goals using a structured SI documentation template. Seventeen nurse and 3 social work case managers in an Accountable Care Organization (ACO) in a large health system in a western suburb of Chicago participated in this project. The practice setting was the primary care clinics associated with the health system. Patients eligible for the project met the SI criteria and were part of the organization's ACO or Bundle Payment for Care Improvement program. Twenty members of the case management staff participated in a 4-hr face-to-face educational program, based in part on review of best practices related to SI care and communication. Participants completed a pre- and posttest survey of knowledge; self-rated their confidence in conducting SI conversations; and evaluated the educational program. Participants then engaged in the established protocol inclusive of the following: (1) identify patients appropriate for an SI conversation; (2) initiate the SI conversation; and (3) document components of the SI in the electronic medical record. Educational Program: Ninety-five percent of the RN and SW case managers reported that that the educational module objectives were met to a moderate or great extent. One hundred percent of the participants reported that the format to deliver the program was effective, the content of the program was directly relevant to their clinical practice, and they would change their practice because of learning/understanding the content in the program. Educational program pretest scores ranged from 46.2% to 84.6%, with posttest scores ranging from 69.2% to 100%. A paired-samples t test demonstrated a statistically significant increase in posttest scores. Baseline confidence scores ranged from 1 to 4, with postproject confidence scores ranging from 2 to 4. A paired-samples t test demonstrated a statistically significant increase in confidence.Serious Illness Protocol: The case managers correctly identified 92% of patients who met the established SI identification criteria for this project. In 91.8% of cases, the case managers conducted an SI conversation in adherence to the protocol. In 76% of the cases, documentation about the SI conversation was completed in accordance with the protocol. .

790-P: Multicomponent Integrated Care Program Benefits on Diabetes-Related Grief and Stage of Change and Glycemic Control Association

Self-care behavior is the cornerstone in diabetes care. Strategies to promote behavior change and overcome grief process to improve diabetes outcomes have been poorly studied. We examined a quality initiative Multicomponent Integrated Care (MIC) program on Grief Stage (GS) and Stage of Change (SOC) allocation and its association with A1c in persons with type 2 diabetes (PwT2D) in a public primary care T2D clinic. DIABEMPIC is a 5-months empowerment-based program including: interdisciplinary case management team, diabetes self-management education, individual/group sessions, shared medical appointments, audit and feedback, and guaranteed supply of medications. We evaluated the effect of the intervention using a ’before and after’ design. Advanced stages were defined by higher than “anger” and higher than “contemplation” for GS and SOC, respectively. Total PwT2D were 451, the mean (SD) age was 54.6 (11) years, 66% were female, diabetes duration was 12 (8) years and baseline A1c was 9.5% (2.1). Baseline GS: denial 43.6%, anger 25.1%, bargaining 22.8%, depression 8.2% and acceptance 0.3%. Baseline SOC: precontemplation 55.4%, contemplation 40.6%, determination 2.5%, action 2.5% and maintenance 0%. GS and SOC improved after the intervention (83% and 68.7% presented advanced stages, respectively), p&amp;lt;0.001. A1c decreased 2.7% (2.2), p-value &amp;lt;0.001. Advanced GS and SOC were associated with an A1c ≦ 8% (OR 0.29, 95% CI, 0.16-0.52 and OR 0.21, 95% CI, 0.12-0.38, respectively). Also, these advanced stages had higher decrease of A1c (-0.8, -0.7%, respectively) than those who persist in earlier stages (p&amp;lt;0.001). We report a high prevalence of initial GS and SOC in PwT2D and poor glycemic control. MIC program participation was associated with improving GS and SOC. Advanced stages of GS and SOC at the end of the program were associated with better glycemic control. MIC strategies must be considered to promote behavior change and overcome grief process in PwT2D. Disclosure R. Silva-Tinoco: Speaker’s Bureau; Self; Novo Nordisk Inc. O. Salas-Martínez: None. V. delaTorre-Saldaña: None. E.B. Guzman: None. E.C. Cuatecontzi: None. D. Cabrera-Gerardo: None. L. Castillo-Martinez: None. H. Gallardo-Rincón: None. J. Serna: None. A. Gonzalez-Cantu: None. M. Romero-Ibarguengoitia: None.

Hidradenitis Suppurativa: Our Experience with a Surgical Case Management Team

Background and objectivesThe complexity of hidradenitis suppurativa (HS) treatment calls for a multidisciplinary approach. We therefore created a multidisciplinary team to manage surgical care. This study aimed to describe the clinical characteristics of the patients we evaluated and the outcomes of the surgical techniques used. Material and methodsDescriptive cross-sectional study of 104 patients evaluated by our surgical case management team between September 2015 and July 2018. ResultsSurgery was used to treat 46% of the patients with HS who were evaluated. Most were men (73%) with no family history of HS (63%) and smokers or former smokers (76%). Gluteal HS comprised the largest phenotype group (41%) and the majority of cases were serious (Hurley stage II, 36%; stage III, 46%). The anatomical regions with the largest number of lesions were the axillae (51.9%) and the groin (41.3%). Surgery was most often performed in the axilla (38.3%), followed by the gluteus (23.4%). The most common drug treatment was a combination of rifampicin and clindamycin, Deroofing was the technique used most often (in 48% of the patients who underwent surgery). Postoperative outcomes were assessed as satisfactory overall in 63.4% of the cases. The HS lesion recurred in 20% and 12% developed wound dehiscence. ConclusionsOur experience leads us to recommend forming multidisciplinary teams to improve communication between specialists, provide tailored treatment for the patient with HS, and improve follow-up.