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Hospital throughput

Guojun Zhang, Guanghui Zheng, Yan Zhang, Ruimin Ma, Xixiong Kang
Post-neurosurgical meningitis (PNM) is one of the most severe hospital-acquired infections (HAI) worldwide, and a large number of pathogens, especially those possessing multi-resistance genes, are related to these infections. Existing methods for detecting bacteria and measuring their response to antibiotics lack sensitivity and stability, and laboratory-based detection methods are inconvenient, which require at least 24h to complete. Rapid identification of bacteria and the determination of their susceptibility to antibiotics are urgently needed, in order to combat the emergence of multi-resistant bacterial strains...
March 17, 2018: International Journal of Infectious Diseases: IJID
Hayley B Gershengorn, Carri W Chan, Yunchao Xu, Hanxi Sun, Ronni Levy, Mor Armony, Michelle N Gong
OBJECTIVE: To understand the impact of adding a medical step-down unit (SDU) on patient outcomes and throughput in a medical intensive care unit (ICU). DESIGN: Retrospective cohort study. SETTING: Two academic tertiary care hospitals within the same health-care system. PATIENTS: Adults admitted to the medical ICU at either the control or intervention hospital from October 2013 to March 2014 (preintervention) and October 2014 to March 2015 (postintervention)...
January 1, 2018: Journal of Intensive Care Medicine
He-Shan Zheng, Wan-Qian Guo, Qu-Li Wu, Nan-Qi Ren, Jo-Shu Chang
Hospital wastewater is one of the possible sources responsible for antibiotic resistant bacteria spread into the environment. This study proposed a promising strategy, electro-peroxone (E-peroxone) pretreatment followed by a sequencing batch reactor (SBR) for simulated hospital wastewater treatment, aiming to enhance the wastewater treatment performance and to reduce antibiotic resistance genes production simultaneously. The highest chemical oxygen demand (COD) and total organic carbon (TOC) removal efficiency of 94...
March 15, 2018: Environment International
S-M Lee, K Gordon, R McMillan, F Crystal, P Acher
Introduction Transurethral resection of the prostate has remained the most common operation for bladder outlet obstruction in the UK, but it is associated with potential morbidity and median two-day length of hospital stay. Holmium laser enucleation of the prostate (HoLEP) provides an alternative procedure. Provision of day-case HoLEP would improve patient care through increased efficiency. We assessed the feasibility and safety of day-case HoLEP and examined predictive factors for increased length of hospital stay...
March 15, 2018: Annals of the Royal College of Surgeons of England
Akira Kuriyama, Tetsunori Ikegami, Toshie Kaihara, Toshio Fukuoka, Takeo Nakayama
OBJECTIVE: The Japan Acuity and Triage Scale (JTAS) was developed based on Canadian Triage and Acuity Scale in 2012 and has been implemented in many Japanese EDs. We assessed the validity of JTAS by examining the association between JTAS triage levels and throughput and clinical outcomes in adult patients. METHODS: We conducted a retrospective analysis of prospectively collected clinical data in the ED of a Japanese tertiary-care hospital. We included self-presenting patients who were ≥16 years of age and triaged between June 2013 and May 2014...
March 13, 2018: Emergency Medicine Journal: EMJ
Jejo D Koola, Sharon E Davis, Omar Al-Nimri, Sharidan K Parr, Daniel Fabbri, Bradley A Malin, Samuel B Ho, Michael E Matheny
OBJECTIVE: Hepatorenal Syndrome (HRS) is a devastating form of acute kidney injury (AKI) in advanced liver disease patients with high morbidity and mortality, but phenotyping algorithms have not yet been developed using large electronic health record (EHR) databases. We evaluated and compared multiple phenotyping methods to achieve an accurate algorithm for HRS identification. MATERIALS AND METHODS: A national retrospective cohort of patients with cirrhosis and AKI admitted to 124 Veterans Affairs hospitals was assembled from electronic health record data collected from 2005 to 2013...
March 9, 2018: Journal of Biomedical Informatics
Nicolas Garcelon, Antoine Neuraz, Rémi Salomon, Hassan Faour, Vincent Benoit, Arthur Delapalme, Arnold Munnich, Anita Burgun, Bastien Rance
INTRODUCTION: Clinical data warehouses are often oriented toward integration and exploration of coded data. However narrative reports are of crucial importance for translational research. This paper describes Dr Warehouse®, an open source data warehouse oriented toward clinical narrative reports and designed to support clinicians' day-to-day use. METHOD: Dr Warehouse relies on an original database model to focus on documents in addition to facts. Besides classical querying functionalities, the system provides an advanced search engine and Graphical User Interfaces adapted to the exploration of text...
March 1, 2018: Journal of Biomedical Informatics
Thomas H McCoy, Sheng Yu, Kamber L Hart, Victor M Castro, Hannah E Brown, James N Rosenquist, Alysa E Doyle, Pieter J Vuijk, Tianxi Cai, Roy H Perlis
BACKGROUND: Relying on diagnostic categories of neuropsychiatric illness obscures the complexity of these disorders. Capturing multiple dimensional measures of neuropathology could facilitate the clinical and neurobiological investigation of cognitive and behavioral phenotypes. METHODS: We developed a natural language processing-based approach to extract five symptom dimensions, based on the National Institute of Mental Health Research Domain Criteria definitions, from narrative clinical notes...
February 23, 2018: Biological Psychiatry
Ali Elfandi, Jordan G Safirstein
PURPOSE OF REVIEW: The evolution of cardiac catheterization has led to the development of well-refined, more effective, and safer devices that allow cardiovascular interventionalists to deliver high-quality percutaneous interventions (PCI). Transradial PCI (TRI) has gained more popularity in the USA over the past 10 years, and as experience and volume of TRI grow, studies adopting same day radial PCI protocols have emerged and are showing promising results. We sought to review the current literature on TRI and same day discharge (SDD)...
February 24, 2018: Current Treatment Options in Cardiovascular Medicine
Muhsin Aydin, Jacqueline Carter-Conger, Ning Gao, David F Gilmore, Steven C Ricke, Soohyoun Ahn
Salmonella is one of major foodborne pathogens and the leading cause of foodborne illness-related hospitalizations and deaths. It is critical to develop a sensitive and rapid detection assay that can identify Salmonella to ensure food safety. In this study, a DNA sensor-based suspension array system of high multiplexing ability was developed to identify eight Salmonella serovars commonly associated with foodborne outbreaks to the serotype level. Each DNA sensor was prepared by activating pre-encoded microspheres with oligonucleotide probes that are targeting virulence genes and serovar-specific regions...
February 19, 2018: Analytical and Bioanalytical Chemistry
Md Shamim Ahasan, Thomas B Waltzek, Roger Huerlimann, Ellen Ariel
Stranded green turtles (Chelonia mydas) are often cared for in rehabilitation centers until they recover. Although the specific causal agents of diseases in stranded turtles are difficult to diagnose, we know that gut microbiota of green turtles play a vital role in health as well as a wide range of diseases. The objective of this study was to characterize and compare the gut bacterial communities between pre-hospitalization (PH) and post-rehabilitation (PR) stranded green turtles using high-throughput sequencing analysis targeting V1-V3 regions of the bacterial 16S rRNA gene...
March 2018: Microbiological Research
Mandreker Bahall
BACKGROUND: Throughput might be partially responsible for sub-optimum organisational and medical outcomes. The present study examined throughput and the challenges to ensuring optimum throughput in hospitals, and determined the effectiveness of a throughput intervention in reducing overcrowding in a public healthcare institution in Trinidad and Tobago. METHODS: First, a literature review of throughput and its processes in relation to improving hospital care was conducted...
February 20, 2018: BMC Health Services Research
Maged A Tanios, Daniel Teres, Hyunsoon Park, Antonio Beltran, Arunpal Sehgal, James D Leo
BACKGROUND: Various intensivist staffing models have been suggested, but the long-term sustainability and outcomes vary and may not be sustained. We examined the impact of implementing a high-intensity intensivist coverage model with a nighttime in-house nocturnist (non-intensivist) and its effect on intensive care unit (ICU) outcomes. METHODS: We obtained historical control baseline data from 2007 to 2011 and compared the same data from 2011 to 2015. The Acute Physiological and Chronic Health Evaluation outcomes system was utilized to collect clinical, physiological, and outcome data on all adult patients in the medical ICU and to provide severity-adjusted outcome predictions...
January 1, 2018: Journal of Intensive Care Medicine
Kate M Quigley, Patricia A Warner, Line K Bay, Bette L Willis
Determining the extent to which Symbiodinium communities in corals are inherited versus environmentally acquired is fundamental to understanding coral resilience and to predicting coral responses to stressors like warming oceans that disrupt this critical endosymbiosis. We examined the fidelity with which Symbiodinium communities in the brooding coral Seriatopora hystrix are vertically transmitted and the extent to which communities are genetically regulated, by genotyping the symbiont communities within 60 larvae and their parents (9 maternal and 45 paternal colonies) using high-throughput sequencing of the ITS2 locus...
February 17, 2018: Heredity
Miquel Sánchez, Montse Suárez, María Asenjo, Ernest Bragulat
Objective: To apply lean thinking in triage acuity level-3 patients in order to improve emergency department (ED) throughtput and waiting time. Design: A prospective interventional study. Setting: An ED of a tertiary care hospital. Participants: Triage acuity level-3 patients. Intervention(s): To apply lean techniques such as value stream mapping, workplace organization, reduction of wastes and standardization by the frontline staff...
February 13, 2018: International Journal for Quality in Health Care
Yuri Hatazawa, Yoshihiko Yano, Rina Okada, Toshihito Tanahashi, Hiroki Hayashi, Hirotaka Hirano, Akihiro Minami, Yuki Kawano, Motofumi Tanaka, Takumi Fukumoto, Yoshiki Murakami, Masaru Yoshida, Yoshitake Hayashi
Background: Hepatocellular carcinoma (HCC) can develop in patients who are negative for the hepatitis B surface antigen (HBsAg) in serum but positive for hepatitis B virus (HBV) DNA in the liver, referred to as occult HBV infection (OBI). Previous reports showed that HBV variants in OBI-related HCC are different from those in HBsAg-positive HCC. In the present study, HBV quasispecies based on the pre-S/S gene in OBI-related HCC patients were examined by high throughput sequencing and compared with those in HBsAg-positive HCC...
2018: Infectious Agents and Cancer
W H van Harten, N Goedbloed, A H Boekhout, S Heintzbergen
BACKGROUND: In general, patients with a cancer suspicion visit the hospital multiple times before diagnosis is completed. Using various "operations management" techniques a few fast track diagnostic services were implemented in the Netherlands Cancer Institute (NKI) in 2006. Growing patient numbers and increasing process complexity, led to diminished service levels. To decrease the amount of patient visits and to extend these services beyond the (obvious) breast cancer services, fast track diagnostics is now implemented for all 18 cancer types that present with a frequency of minimally one per week...
February 7, 2018: BMC Health Services Research
Xin-Lei Gao, Ming-Fei Shao, Qing Wang, Li-Tao Wang, Wen-Yan Fang, Feng Ouyang, Ji Li
Clinically relevant antibiotic-resistant bacteria (ARB) and antibiotic resistance genes (ARGs) in bioaerosols have become a greater threat to public health. However, few reports have shown that ARB and ARGs were found in the atmosphere. High-throughput sequencing applied to environmental sciences has enhanced the exploration of microbial populations in atmospheric samples. Thus, five nosocomial bioaerosols were collected, and the dominant microbial and pathogenic microorganisms were identified by high-throughput sequencing in this study...
February 2, 2018: Journal of Hazardous Materials
Janne Cadamuro, Martin Gaksch, Helmut Wiedemann, Giuseppe Lippi, Alexander von Meyer, Astrid Pertersmann, Simon Auer, Cornelia Mrazek, Ulrike Kipman, Thomas K Felder, Hannes Oberkofler, Elisabeth Haschke-Becher
BACKGROUND: Inappropriate utilization of laboratory resources is an increasing concern especially in high-throughput facilities. Until now, no reliable information has been published addressing to which extent laboratory results are actually used for clinical decision-making. Therefore, we aimed to close this gap using a novel retrospective approach including a survey of clinicians and nurses. METHODS: We retrospectively evaluated the number of re-orders for potassium (K), lactate dehydrogenase (LD), aspartate-aminotransferase (AST), activated partial thromboplastin-time (APTT) and prothrombin-time/INR (PT/INR), after the initial order had to be cancelled due to preanalytical non-conformities...
February 2, 2018: Clinical Biochemistry
Gonzalo Yebra, Dan Frampton, Tiziano Gallo Cassarino, Jade Raffle, Jonathan Hubb, R Bridget Ferns, Laura Waters, C Y William Tong, Zisis Kozlakidis, Andrew Hayward, Paul Kellam, Deenan Pillay, Duncan Clark, Eleni Nastouli, Andrew J Leigh Brown
BACKGROUND & METHODS: The ICONIC project has developed an automated high-throughput pipeline to generate HIV nearly full-length genomes (NFLG, i.e. from gag to nef) from next-generation sequencing (NGS) data. The pipeline was applied to 420 HIV samples collected at University College London Hospitals NHS Trust and Barts Health NHS Trust (London) and sequenced using an Illumina MiSeq at the Wellcome Trust Sanger Institute (Cambridge). Consensus genomes were generated and subtyped using COMET, and unique recombinants were studied with jpHMM and SimPlot...
2018: PloS One
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