Interdisciplinary Patient Care Research Articles

A85 ASSESSING THE IMPACT OF A DEDICATED RAPID INTERDISCIPLINARY IBD CLINIC ON PATIENT WAIT TIMES, REPORTED OUTCOMES, AND SATISFACTION OF CARE

Abstract Background Inflammatory bowel disease (IBD) is a chronic fluctuating condition where patients can experience periods of active disease and remission. Timely access to care has been shown to be impactful on important disease outcomes. In January 2020, we implemented a rapid assessment IBD program consisting of expedited access to interdisciplinary care and close monitoring of patients. Purpose To assess the impact of the rapid assessment program on access to care, disease activity, and patient satisfaction. Method Once informed consent was obtained, patients were enrolled into the RAPID IBD program. This program consisted of four close monitoring time points at baseline, 1, 2, and 3 months, as well as two follow up time points at 6 and 12 months. At each timepoint patients completed questionnaires that evaluated disease activity, using the Modified Harvey Bradshaw Index (mHBI) for Crohn’s disease (CD), partial Mayo (pMayo) score and Simple Clinical Colitis Activity Index (SCCAI) for ulcerative colitis patients. At baseline, 3, 6, and 12 months, patients were also assessed on mental health, using the Patient Health Questionnaire (PHQ-9) and General Anxiety Disorder (GAD-7), and satisfaction of care, using the CACHE questionnaire. Result(s) Between January 2020 – August 2021, 216 patients were referred to the RAPID IBD program. The mean time from referral to clinical assessment was 8.1 days. Of those referred, 143 (71 CD, 62 UC, 6 IBDU, and 4 Query IBD) patients consented to and completed the 12-month RAPID IBD study. 34.9% of patients who had active disease at baseline achieved remission by 3 months (Table 1). At baseline 44.8% and 28.4% of patients experienced moderate to severe depression and anxiety, respectively. The greatest improvement in mental health was seen at 2 months where the proportion of patients experiencing moderate to severe depression and anxiety decreased to 27.5% and 18.3%, respectively (Table 2). Patient satisfaction, specific to clinical care, improved from a baseline score of 69.1% to 74.1% at 3 months (Table 3). Image Conclusion(s) Implementation of a dedicated RAPID IBD clinic program reveals shorter wait times to be seen in clinic. By three months of enrollment, patients demonstrate improvements in clinical response, mental health, and satisfaction of care. Please acknowledge all funding agencies by checking the applicable boxes below Other Please indicate your source of funding; AMO Innovation Funding Disclosure of Interest None Declared

Education Research: The Inappropriate Consult

Background and Objectives As resident physicians specialize, they lose familiarity with knowledge central to other fields. This can yield what we term the dual fallacies: (1) the sense that their own expertise is common knowledge, and (2) unfamiliar clinical situations seem beyond their scope. In graduate medical education, these dual fallacies may engender the perception of inappropriate consults among specialties. This project evaluated biases in residents' perceptions of expected knowledge and inappropriate consults to improve interdisciplinary education among neurology residents (neurologists) and internal medicine residents (internists). Secondarily, we evaluated whether these biases were mitigated after implementing an educational intervention. Methods Resident neurologists and internists at a large, urban, academic medical center answered board-style questions reflecting neurology and medicine consultation scenarios. They then rated the extent to which each scenario reflected common knowledge to both specialties and whether a consult was warranted. After revising the internal medicine residency curriculum to include a neurology rotation, another cohort of residents was surveyed and participated in semistructured interviews. Paired sample t tests and qualitative data analysis were performed. Results Neurologists and internists participated in phase 1 (n = 23) and phase 2 (n = 42) of the study. Residents from both fields answered more questions correctly from their own specialty than the other in phase 1 (p < 0.05) and phase 2 (p < 0.001). Neurologists and internists in both cohorts thought that each other should know more neurology answers than they actually did (p < 0.05). Neurologists were less likely to agree than internists that medicine questions deserved a consult (p = 0.014). Interviews revealed themes regarding perceived consult appropriateness, affected by educational, communication, clinical, and administrative factors. In addition, residents agreed that appropriate consults must pose a specific question and occur only after an initial investigation was performed, but that this rarely happens. Discussion Our findings support that discordant expectations of expertise contribute to a perception of inappropriate consults among neurologists. Nonclinical factors, from cognitive biases to contextual considerations, inform clinical consultation and interdisciplinary patient care. Implementing rotations on other services alone is insufficient to eradicate discordant expectations; however, we propose additional interventions that may prove valuable in medical education.

Interdisciplinary care of pediatric oncology patients: A survey of clinicians in Central America and the Caribbean.

Quality cancer care depends on interdisciplinary communication. This study explored the communication practices of interdisciplinary clinicians, the types of healthcare services for which they engage in interdisciplinary collaboration, and the association between interdisciplinary care and perceived quality of care, as well as job satisfaction. We conducted a survey of interdisciplinary clinicians from cancer centers in Guatemala, Honduras, Panama, El Salvador, and Haiti. The survey included 68 items including previously validated tools and novel questions. Total 174 interdisciplinary clinicians completed the survey: nurses (n=60), medical subspecialists (n=35), oncologists (n=22), psychosocial providers (n=20), surgeons (n=12), pathologists (n=9), radiologists (n=9), and radiation oncologists (n=5). Oncologists reported daily communication with nurses (95%) and other oncologists (91%). While 90% of nurses reported daily communication with other nurses, only 66% reported daily communication with oncologists, and more than 50% of nurses reported never talking to pathologists, radiologists, radiation oncologists, or surgeons. Most clinicians described interdisciplinary establishment of cancer treatment goals and prognosis (84%), patient preferences (81%), and determination of first treatment modality (80%). Clinicians who described more interdisciplinary collaboration had higher job satisfaction (p=.04) and perceived a higher level of overall quality of care (p=.004). Clinicians in these limited resource settings describe strong interdisciplinary collaboration contributing to higher job satisfaction and perceived quality of care. However, nurses in these settings reported more limited interdisciplinary communication and care. Additional studies are necessary to further define clinical roles on interdisciplinary care teams and their associations with patient outcomes.

Successful Design and Implementation of a POEM Program for Achalasia in an Integrated Healthcare System.

Per Oral Endoscopic Myotomy (POEM) is a minimally invasive treatment for achalasia with results comparable to laparoscopic Heller myotomy (LHM). Studies have described the development of proficiency for endoscopists learning to perform POEM, and societies have defined educational and technical objectives for advanced endoscopy fellows in training. However, there is limited guidance on the organizational strategy and educational plan necessary to develop an achalasia service with POEM expertise. We aim to outline the steps for design and implementation of a successful POEM program. We reported our experience developing a multi-disciplinary clinical program for POEM and the steps taken to achieve procedural proficiency. We also reported our technical success (successful tunneling into the gastric cardia and myotomy of LES muscle fibers) and clinical success (post-procedure Eckardt score ≤ 3) at 3-6months and 12months post-procedure. Adverse events were classified per the ASGE lexicon for endoscopic adverse events. After creating a multi-disciplinary clinical program for achalasia and completing procedural proficiency for POEM, our technical success rate was 100% and clinical success rate 90% for the first 41 patients. One adverse event (2.4%) occurred, moderate in severity per the American Society of Gastrointestinal Endoscopy (ASGE) lexicon for adverse endoscopic events. In this study, we outlined the steps involved to establish a POEM service in a large integrated healthcare system. Prior competency in interventional endoscopy, procedural training models, POEM observation and education, proctorship, and interdisciplinary patient care are recommended.

Chronic diseases in the context of integrated health and social care

The task of improving the quality of medical care for patients with chronic diseases is considered a priority for the healthcare system, which requires a personalized model of medical and social care focused on the needs of patients with chronic pathology. The article aims to conceptualize the continuum of interdisciplinary care for patients with chronic diseases in disease conditions. The levels of integrated medical and social care for patients with chronic diseases are determined, according to the authors, by the dynamics of the patients quality of life mediated by the relevant condition of the disease. This article presents the practice of multilevel integration of medical and social care for patients with chronic diseases in disease conditions. The authors believe that prospective studies of the content of integrated care related to the study of the optimal ratio of medical and social components of the continuum in disease conditions will help solve the complex problem of improving the quality of medical care for patients with chronic diseases.

The German version of the neurofibromatosis 2 impact on quality of life questionnaire correlates with severity of depression and physician-reported disease severity

BackgroundNeurofibromatosis type 2 (NF2) is a rare genetic disease that causes a wide range of disabilities leading to compromised quality of life (QOL). There is clear need for a validated disease-specific tool to assess quality of life among German-speaking patients with neurofibromatosis type 2 (NF2). The NFTI-QOL questionnaire has produced useful results in English-speaking cohorts. The aim of this study was to produce and validate a German version of the NFTI-QOL (NFTI-QOL-D) and to correlate QOL scores with a depression score (PHQ-9) and clinical disease severity.MethodsThe original English-language NFTI-QOL was translated into German and then back-translated in order to preserve the questionnaire’s original concepts and intentions. A link to an online survey encompassing the NFTI-QOL-D and the PHQ-9 depression questionnaire was then sent to 97 patients with NF2 by email. The respondents’ scores were compared to clinician-reported disease severity scores.Results77 patients completed the online survey in full. Internal reliability among NFTI-QOL-D responses was strong (Cronbach’s alpha: 0.74). Both PHQ-9 and clinician disease severity scores correlated with NFTI-QOL-D scores (Pearson’s rho 0.63 and 0.62, respectively).ConclusionsThe NFTI-QOL-D is a reliable and useful tool to assess patient-reported QOL in German-speaking patients with NF2. The correlation of QOL with both psychological and physical disease parameters underlines the importance of individualized interdisciplinary patient care for NF2 patients, with attention paid to mental well-being as well as to somatic disease manifestations.

Implementation and expansion of inpatient and ambulatory pharmacist credentialing and privileging at an academic medical center.

This article highlights one academic medical center's effort to implement a complete credentialing and privileging (C&P) process for both inpatient and ambulatory clinical pharmacists. The C&P process offers a recognized method to advance pharmacy practice. Credentialing is defined as a process whereby an individual is deemed qualified in a specific subject matter area. Privileging is the process whereby an institution grants authority to an individual to perform services based on credentials. Federal guidelines permit pharmacists to obtain the same level of privileges as professional medical staff, such as physicians, if relevant state laws allow for the corresponding pharmacist scope of practice. States establish laws and regulations that specify the scope of practice for various types of licensed healthcare professionals, including pharmacists. Many health systems have attempted pharmacist C&P practices in both the inpatient and ambulatory care setting with varying degrees of success and reach. Privileged pharmacists provide established benefits and value to other members of the healthcare team. Oregon Health & Science University (OHSU) pursued C&P for both inpatient and ambulatory clinical pharmacists. Initiation and implementation processes were complex and accompanied by a variety of challenges. OHSU operates with advanced pharmacy practice integrated into the interdisciplinary patient care team. Pharmacist C&P allows pharmacists to demonstrate significant clinical benefits and quality improvement in patient care delivery in both inpatient and ambulatory settings.

Perspectives and Attitudes of General Practitioners Towards Pharmacological and Non-Pharmacological COPD Management in a Belgian Primary Care Setting: A Qualitative Study.

Chronic obstructive pulmonary disease (COPD) is a complex and heterogeneous condition that requires multidisciplinary management. In Belgium, the treatment of COPD is mainly managed by general practitioners (GPs). Several clinical practice guidelines (CPGs) recommend the use of non-pharmacological treatments, such as pulmonary rehabilitation, and interdisciplinary care for COPD patients. Although considerable research has been devoted to addressing the multitude of reasons for the lack of adherence to these aspects of the CPGs, less attention has been paid to understanding the perspectives and attitudes of GPs that lead to this suboptimal implementation. This study aimed to 1) explore Belgian GPs' perceptions regarding COPD management in a primary care setting and 2) collect their views on the importance of pulmonary rehabilitation and interprofessional care in COPD management. A descriptive study, conducted between August 2014 and May 2015, used interviews from a sample of 30 Flemish GPs. Data were analyzed following the principles of thematic analysis. COPD management was patient-centered, focusing on immediate symptom relief and reducing future risks through pharmacotherapy and proper patient education. Deviations from the CPGs were noted, with only a few GPs performing spirometry themselves. Conditions to prescribe respiratory physiotherapy were not well known. Some GPs remained unconvinced about the (cost-)effectiveness of respiratory physiotherapy despite the fast-expanding scientific evidence. Interprofessional care was limited to GP-respiratory physician (re)-referral and communication. GPs showed a reactive attitude towards interprofessional collaboration for non-pharmacological therapies, which is not in line with the proactive approach recommended in CPGs. GPs managed COPD patients mainly by reducing symptoms with pharmacological therapy. Integrated care regarding non-pharmacological treatments was not well implemented due to the obstacles in interprofessional collaboration. Future care models incorporating personalized care planning could provide a solution to manage COPD's complex healthcare demands.

Allied Health Professional Students' Perceptions on Research: A Multi-disciplinary Mixed-Methods Study.

Modern medicine necessitates evidence-based interdisciplinary patient care. Research is at the centre of fostering an evidence-based mindset in healthcare teams. Studies have demonstrated that exposing students to research translates into better patient care. Studies investing the perceptions of students towards research have focused on the views of medical students, leaving the perceptions of allied health professional (AHP) students unaccounted for. A mixed-methods, anonymous online questionnaire was distributed to 837 AHP students studying at the University of Malta, across five different courses. The collected data was then statistically analysed through descriptive statistics and chi-square testing. Qualitative results were coded, triangulated and subsequently analysed. An overall response rate of 28.43% was achieved. Only 2.49% of respondents managed to publish research, despite many participants stating that research is important for their future careers. Career progression and lack of opportunity were identified as the major motivating and stumbling factors, respectively. Students pursuing research-focused degrees considered their curriculum to sufficiently equip them with research skills, compared to students studying clinically oriented degrees (p < 0.01). The results obtained from this study indicate that the perceptions of AHP students towards research are on par with the already established medical students. AHP students face the same stumbling blocks, are driven by the same motivating factors and experience a similar disparity between interest in research and research being produced, as medical students. Thus, a joint effort, between stakeholders in medical and AHP students' education, should be taken to address the factors limiting undergraduate students from conducting research. This will enable the implementation of an evidence-based mindset in the clinic, ultimately resulting in better patient care. The online version contains supplementary material available at 10.1007/s40670-022-01715-6.

Traumatology-an interdisciplinary task: exclusively for educational purposes?

Traumatology of the head and neck region is not only apart of otorhinolaryngology, but also has alarge overlap with neighboring disciplines of the head and neck region. In Freiburg, an interdisciplinary lecture on "ENT emergencies" was implemented in the 21/22 winter semester. The aim was to provide an even more realistic view on interdisciplinary patient care and to make evident the areas of intersection of four of the major head disciplines (otorhinolaryngology, neurosurgery, ophthalmology, and maxillofacial surgery). Anew, special lecture in otorhinolaryngology was implemented as part of the regular online lecture series accompanying the semester. With reference to the clinical care of ENT emergencies, possible overlaps with neighboring disciplines were identified and explained by the discipline representatives or discussed in front of and with the auditorium. At the end of the semester, all participating students (n = 173) were invited to evaluate the seminar using the survey tool "EvaSys" (EvaSys GmbH, Lüneburg, Germany). In total, 78students participated in the evaluation process. The new lecture concept was very well accepted and immediately ranked top among the interdisciplinary lecture titles within the ENT lecture series. The clear communication of the term "interdisciplinarity" in the sense of acomplementary clinical cooperation was also very successful and was appreciated accordingly by students during the evaluation process. Pragmatic presentation of ideal clinical patient care using an interdisciplinary approach is possible within the regular ENT lecture series. This realistic portrayal, beyond any technical and/or professional differences, is of great interest to students and is considered clinically relevant. Thus, interdisciplinary lectures provide avaluable tool to teach the fundamental values of clinical interdisciplinary management for the best possible patient care.

Diagnosis and Management of Keratoconus-A Narrative Review of Clinicians' Perspectives.

This review discusses the current practices, attitudes, and trends in diagnosing and managing keratoconus (KC) in adults and children by optometrists and ophthalmologists in order to highlight the differences on a global scale. Two independent reviewers searched the electronic databases and grey literature for all potential articles published from 1 January 2000 to 1 June 2022 on management of KC. Keywords used in searches included "keratoconus", "diagnosis", "management", "treatment", "attitude", "practices", "opinion", "optometrist", "ophthalmologist", "consensus", and "protocol". A total of 19 articles was included in this review-12 from the database search and seven from the grey literature. Although a common stepwise approach of non-surgical management was noted, there were differences in the rates of prescribing rigid gas permeable lenses. Furthermore, while clinicians agreed on the need for early diagnosis, the timeline and type of referral varied significantly. A similar discordance was found in the milestones for surgical intervention and preferred surgical techniques. Practice patterns in keratoconus diagnosis and management vary throughout the world. Multiple recommendations and suggestions to minimise the differences have been provided in the literature, with the main themes being improvement in education, interdisciplinary patient care, and further research to reach consensus.

Monitoring of Patient-Reported Outcomes in Patients with Bleeding Disorders to Assure Quality of Care: Results from a Single Outpatient Haemophilia Treatment Centre in Germany

Background: By collecting certain treatment data during patient's care and comparing these data over time, reliable findings are obtained on whether and at which points there is a need for improvement. Due to the complexity and high risk of complications in the treatment of blood coagulation disorders, an interdisciplinary care of patients is needed to ensure a high-quality and efficient therapy. The Coagulation Treatment Centre rhein-ruhr (GZRR) follows a holistic treatment concept providing cross-sectoral care through interdisciplinary cooperation. This approach is intended also to improve patients' treatment satisfaction (TS), physical functioning (PF) and health-related quality of life (HRQoL). The aim was to evaluate TS, PF and HRQoL in patients treated at the GZRR. Methods: Since 2019 patients > 5 years attending the routine visits at the GZRR completed validated and standardised patient-reported outcomes (PROs) at each visit. Patients > 12 years filled in the generic SF-36 for the assessment of HRQoL, haemophilia-specific HRQoL is assessed with the Haem-A-QoL (adults) or age-related versions of the Haemo-QoL (kids) questionnaires. For the evaluation of TS and PF haemophilia- and age-group specific questionnaires were administered (Hemo-SatA+P, HEP-Test-Q). Results: 177 patients (range 6-80 years) with bleeding disorders were enrolled, among them 55.9% had haemophilia (Haemophilia A, n=88; Haemophilia B, n=11) and 44.1% had VWD; 57.1% were severely affected. Sixty-eight were children (39%) with a mean age of 11.44±3.4 years and BMI of 18.82±3.7; 109 were adults with a mean age of 38.79±16.7 years and BMI of 25.72±5.5. Patients were relatively satisfied with their treatment, adults reported highest impairments in the domain 'burden', while parents were mainly dissatisfied concerning 'ease & convenience'. Children (C) reported a significantly better (p<.0001) subjective physical functioning compared to adults (A). Both age groups showed highest impairments in the domain 'endurance' (MC=70.69±20.3 vs. MA=51.48±25.4). Patients reported good HRQoL in the Mental Component Score of the SF-36 50.07±11.1 and showed some impairments in the Physical Component Score 45.26±11.9; significant difference were found between children and adults in all subdomains of the SF-36. Conclusions: These findings demonstrate that the interdisciplinary approach leads to good results in PROs. Based on the findings direct short-term interventions could be administered to solve minor issues. Follow-up data could prove that this kind of quality-of-care assurance helps not only to improve the clinical situation of patients, but also their PRO.

348P Early interdisciplinary palliative care in patients with non-small cell lung cancer: A 24-weeks randomised controlled trial in Southwest China

Effective interventions to improve prognosis in non-small-cell lung cancer (NSCLC) are urgently needed. We assessed the effect of the early integration of interdisciplinary palliative care for patients with NSCLC on the nutritional status, quality of life (QoL), psychological state and cancer pain.

Interprofessional Collaboration in the OR: AQualitative Study of Nurses' Perspectives.

Interprofessional collaboration (IPC) in the OR enhances safe and effective patient care. The aim of this qualitative study was to explore perioperative nurses' perspectives on their contributions to IPC. We conducted a secondary analysis of 19 semistructured interviews with perioperative RNs and completed inductive thematic analysis with subsequent categorization of the themes into the Interprofessional Education for Collaborative Patient-Centred Practice Framework. Nurses expressed the importance of being heard through effective communication, feeling confident in their role, being aware of interdependent roles, and sharing a common understanding. From nurses' perspectives, use of structured processes enabled organization of interdisciplinary patient care. Nurses showed leadership skills when they anticipated the needs of the team and recognized they needed support to develop these skills. They contributed to IPC through their shared understanding of common goals, leadership skills in the OR, and active involvement in delivering structured processes.

Computerized tool and interdisciplinary care for older patients with delirium in the emergency department: a novel model in Taiwan.

A computerized tool and interdisciplinary care were implemented to develop a novel model for older patients with delirium in the emergency department (ED). We developed a computerized tool using a delirium triage screen and brief confusion assessment in the hospital information system, performed education for the healthcare providers, and developed a continuous care protocol. Comparisons for outcomes between pre- and post-intervention periods were performed. Compared with the pre-intervention period, patients in the post-intervention period had shorter hospitalization stay, lower expenditure of hospitalization, more likely to return home, lower ED revisits of ≤ 3days, re-hospitalization of ≤ 14days, and mortality of ≤ 1month. All mentioned differences were not statistically significant. A novel model was successfully developed for delirium management in older patients in the ED. Outcome differences were not significant; however, the result is promising, which gives us an important reference in the future.

1269P Early interdisciplinary palliative care in patients with non-small-cell lung cancer: A 24-weeks randomised controlled trial in Southwest China

Effective interventions to improve prognosis in non-small-cell lung cancer (NSCLC) are urgently needed. We assessed the effect of the early integration of interdisciplinary palliative care for patients with NSCLC on the nutritional status, quality of life (QoL), psychological state and cancer pain.

Development of indicators to assess quality and patient pathways in interdisciplinary care for patients with 14 ambulatory-care-sensitive conditions in Germany

BackgroundIn settings like the ambulatory care sector in Germany, where data on the outcomes of interdisciplinary health services provided by multiple office-based physicians are not always readily available, our study aims to develop a set of indicators of health care quality and utilization for 14 groups of ambulatory-care-sensitive conditions based on routine data. These may improve the provision of health care by informing discussions in quality circles and other meetings of networks of physicians who share the same patients.MethodsOur set of indicators was developed as part of the larger Accountable Care in Deutschland (ACD) project using a pragmatic consensus approach. The six stages of the approach drew upon a review of the literature; the expertise of physicians, health services researchers, and representatives of physician associations and statutory health insurers; and the results of a pilot study with six informal network meetings of office-based physicians who share the same patients.ResultsThe process resulted in a set of 248 general and disease specific indicators for 14 disease groups. The set provides information on the quality of care provided and on patient pathways, covering patient characteristics, physician visits, ambulatory care processes, pharmaceutical prescriptions and outcome indicators. The disease groups with the most indicators were ischemic heart diseases, diabetes and heart failure.ConclusionOur set of indicators provides useful information on patients’ health care use, health care processes and health outcomes for 14 commonly treated groups of ambulatory-care-sensitive conditions. This information can inform discussions in interdisciplinary quality circles in the ambulatory sector and foster patient-centered care.

Real-time analysis and display of quantitative measures to track and improve clinical workflow.

PurposeRadiotherapy treatment planning is a complex process with multiple, dependent steps involving an interdisciplinary patient care team. Effective communication and real‐time tracking of resources and care path activities are key for clinical efficiency and patient safety.Materials and MethodsWe designed and implemented a secure, interactive web‐based dashboard for patient care path, clinical workflow, and resource utilization management. The dashboard enables visualization of resource utilization and tracks progress in a patient's care path from the time of acquisition of the planning CT to the time of treatment in real‐time. It integrates with the departmental electronic medical records (EMR) system without the creation and maintenance of a separate database or duplication of work by clinical staff. Performance measures of workflow were calculated.ResultsThe dashboard implements a standardized clinical workflow and dynamically consolidates real‐time information queried from multiple tables in the EMR database over the following views: (1) CT Sims summarizes patient appointment information on the CT simulator and patient load; (2) Linac Sims summarizes patient appointment times, setup history, and notes, and patient load; (3) Task Status lists the clinical tasks associated with a treatment plan, their due date, status and ownership, and patient appointment details; (4) Documents provides the status of all documents in the patients' charts; and (5) Diagnoses and Interventions summarizes prescription information, imaging instructions and whether the plan was approved for treatment. Real‐time assessment and quantification of progress and delays in a patient's treatment start were achieved.ConclusionsThis study indicates it is feasible to develop and implement a dashboard, tailored to the needs of an interdisciplinary team, which derives and integrates information from the EMR database for real‐time analysis and display of resource utilization and clinical workflow in radiation oncology. The framework developed facilitates informed, data‐driven decisions on clinical workflow management as we seek to optimize clinical efficiency and patient safety.

Sex Disparities in Outcome of Patients with Alcohol-Related Liver Cirrhosis within the Eurotransplant Network-A Competing Risk Analysis.

Alcohol use disorder (AUD) is one of the most important risk factors for the development of alcohol-related liver cirrhosis (ALC). Importantly, psychiatrists are an integral part of the interdisciplinary care for patients with AUD and ALC. The aim of the current study was to investigate whether sex influences the outcome within this group of patients. For this purpose, data of all registrations for liver transplantations due to ALC within the Eurotransplant region from 2010 to 2019 were analyzed for sex disparities using competing risk models and in-between group comparisons. Relevant sex differences in registration numbers (24.8% female) and investigated outcomes were revealed. Risk ratios for a positive outcome, i.e., transplantation (0.74), and those of adverse outcomes, i.e., removal from waiting list (1.44) and death on waiting list (1.10), indicated a relative disadvantage for female patients with ALC. Further, women listed for liver transplantations were significantly younger than their male counterparts. Notably, sex disparities found in registration and outcome parameters were independent of differences found in the prevalence of AUD and liver transplantations. Further research is necessary to identify the underlying mechanisms and establish strategies to ensure equity and utility in liver transplantations due to ALC.

"AHead Start or a Pain in theNeck?"-Establishment and Evaluation of a Video-Based "Hands-On" Head and Neck Ultrasound Course.

The COVID-19 pandemic has strongly highlighted the need for more digitalization in healthcare. Teaching ultrasound skills in online courses is a key challenge in this context. The aim of this study was to establish an online video-based head and neck ultrasound course with an evaluation of the quality, effectiveness, and feasibility of this teaching method compared to in-person teaching. Twenty-two medical students were taught head and neck ultrasound in two groups: one group in an in-person course and the other one in a video-based course. Learning success was analyzed using self-evaluation forms and external assessment by an experienced ultrasonographer. Comparing pre- and post-training self-evaluation, all participants showed statistically significant learning progress. In the external assessment, the overall scores in both groups did not differ significantly. The courses themselves were positively evaluated by all participants. Herein, we present the first feasibility study of a web-based head and neck-ultrasound course for medical students. The methodology provides the potential for future changes in telemedical education and sustainable improvements in telemedical teaching and global intra-clinical and interdisciplinary patient care.