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Hospital throughput

T Ziprian, F Laue, N Ramadanov, U Nienaber, R Volland, R Lefering, G Matthes
BACKGROUND: Registries are becoming increasingly more important in clinical research. The TraumaRegister DGU® of the German Society for Trauma Surgery plays an excellent role with respect to the care of severely injured patients. AIM: Within the framework of this investigation the quality of data provided by this registry was to be verified. MATERIAL AND METHODS: Certified hospitals participating in the TraumaNetzwerk DGU® of the German Society for Trauma Surgery are obliged to submit data of treated severely injured patients to the TraumaRegister DGU®...
September 21, 2018: Der Unfallchirurg
M Ambigavathi, D Sridharan
In recent days, intelligent biomedical sensors and wearable devices are changing the healthcare industry by providing various heterogeneous vital signs of patients to the hospitals, caregivers, and clinicals. This collective form of monitoring sensor devices forms a very short-range Wireless Body Area Network (WBAN) and plays a key role in the data gathering process. If any sensor node in the network detects abnormal values that should be transmitted promptly via wireless medium with less delay. A single medium allows one-way delivery of a data packet, and it may not be sufficient to satisfy the high volume of communication demand between the sensor nodes in the network...
September 20, 2018: Journal of Medical Systems
Jennifer L Dale, Kenneth B Beckman, Julia L E Willett, Jennifer L Nilson, Nagendra P Palani, Joshua A Baller, Adam Hauge, Daryl M Gohl, Raymond Erickson, Dawn A Manias, Michael J Sadowsky, Gary M Dunny
Enterococcus faecalis is a common commensal bacterium in animal gastrointestinal (GI) tracts and a leading cause of opportunistic infections of humans in the modern health care setting. E. faecalis OG1RF is a plasmid-free strain that contains few mobile elements yet retains the robust survival characteristics, intrinsic antibiotic resistance, and virulence traits characteristic of most E. faecalis genotypes. To facilitate interrogation of the core enterococcal genetic determinants for competitive fitness in the GI tract, biofilm formation, intrinsic antimicrobial resistance, and survival in the environment, we generated an arrayed, sequence-defined set of chromosomal transposon insertions in OG1RF...
September 2018: MSystems
Daniel J Lin, Christopher C McConkey, Paul Nankivell, Janet Dunn, Hisham Mehanna
OBJECTIVES: High institutional clinical trial recruitment and high hospital volume are reported to be independent indicators of better patient outcomes following cancer treatment. However, their relationship in head and neck cancers (HNC) remains less clear. METHODS: We aimed to assess the relationship between institutional clinical trial recruitment, hospital throughput of HNC cases, and survival of patients with advanced HNC treated with primary chemoradiotherapy at hospitals which recruited to the PET-NECK trial (2008-2012)...
October 2018: Oral Oncology
Charles J Sande, Martin Mutunga, Jacqueline Muteti, James A Berkley, D James Nokes, James Njunge
The upper airway - which consists mainly of the naso- and oro-pharynx - is the first point of contact between the respiratory system and microbial organisms that are ubiquitous in the environment. It has evolved highly specialised functions to address these constant threats whilst facilitating seamless respiratory exchange with the lower respiratory tract. Dysregulation of its critical homeostatic and defence functions can lead to ingress of pathogens into the lower respiratory tract, potentially leading to serious illness...
September 14, 2018: Scientific Reports
Joonhong Park, Hanwool Cho, Seung Jun Choi, Gun Dong Lee, Sang Hyun Sin, Ji Hyeong Ryu, Hye Sun Park, Hyeyoung Lee, Yonggoo Kim, Eun Jee Oh
The detection and quantification of hepatitis B virus (HBV) DNA plays an important role in diagnosing and monitoring HBV infection as well as in assessing the therapeutic response. We compared the analytical performance of a random access, fully automated HBV assay-DxN VERIS Molecular Diagnostics System (Beckman Coulter, Brea, CA, USA)-with that of Abbott RealTime HBV assay (Abbott Laboratories, Des Plaines, IL, USA). The between-day precision of the VERIS assay ranged from 0.92% (mean 4.68 log IU/mL) to 4...
January 2019: Annals of Laboratory Medicine
Joseph A Izzo, Jonathan Watson, Rahul Bhat, Matthew Wilson, Joseph Blumenthal, Christina Houser, Edward Descallar, Daniel Hoffman, Ethan Booker
OBJECTIVES: Emergency Department crowding is an increasing problem, leading to treatment delays and higher risk of mortality. Our institution recently implemented a telemedicine physician intake ("tele-intake") process as a mitigating front-end strategy. Previous studies have focused on ED throughput metrics such as door to disposition; our work aimed to specifically assess the tele-intake model for clinical accuracy. METHODS: We retrospectively reviewed ED visits at a high acuity, tertiary care academic hospital before and after tele-intake implementation...
August 7, 2018: American Journal of Emergency Medicine
Maggy Mitzkewich
INTRODUCTION: Identifying patients with sepsis at triage can lead to a decrease in door-to-antibiotic time. Our community hospital emergency department's mean door-to-antibiotic time was 105.3 minutes, falling short of the Surviving Sepsis Campaign guideline's benchmark goal of 60 minutes. One of the most common reasons for treatment delays was that patients with sepsis were not identified upon entrance to the emergency department. A solution to the delay was to implement a practice improvement project by having the triage nurse screen all patients for sepsis upon entrance to the emergency department...
September 5, 2018: Journal of Emergency Nursing: JEN: Official Publication of the Emergency Department Nurses Association
Joshua Lyons, Lauren McCaulley, Nicole Maronian, Jeffrey M Hardacre
BACKGROUND: The timing of inpatient discharges can impact hospital throughput with later discharges leading to decreased patient satisfaction, increased length of stay (LOS), and longer boarding times. METHODS: A 12-month targeted intervention that included both pre-operative and inpatient components was implemented across all surgical inpatient services to increase the proportion of patients discharged by noon. RESULTS: Discharge by noon rates increased from 14...
August 28, 2018: American Journal of Surgery
Anthony Bell, Ghasem-Sam Toloo, Julia Crilly, John Burke, Ged Williams, Bridie McCann, Gerry FitzGerald
Objective The acuity and number of presentations being made to emergency departments (EDs) is increasing. In an effort to safely and efficiently manage this increase and optimise patient outcomes, innovative models of care (MOC) have been implemented. What is not clear is how these MOC reflect the needs of patients or relate to each other or to ED performance. The aim of this study was to describe ED MOC in Queensland, Australia. Methods Situated within a larger mixed-methods study, the present study was a cross-sectional study...
September 7, 2018: Australian Health Review: a Publication of the Australian Hospital Association
Jiansheng Huang, Hui Ding, Yang Shi, Yunan Zhao, Xiaolei Hu, Jianmin Ren, Guiying Huang, Rongzhen Wu, Zhigang Zhao
The wide spread of Klebsiella pneumoniae carbapenemase (KPC)-producing Enterobacteriaceae is great threat to public health in China. Plasmids are among the major factors mediating bla KPC gene dissemination. A total of 156 carbapenem-resistant Enterobacteriaceae (CRE) isolates were identified in a tertiary hospital in China. Six KPC-producing isolates, namely, E. coli ( n = 2), E. asburiae ( n = 1), C. freundii ( n = 1), C. portucalensis ( n = 1), and C. koseri ( n = 1), tested positive for the pCKPC18-1-like untypeable plasmid, which was described recently in C...
2018: Frontiers in Microbiology
Ramon V Cortez, Tarissa Petry, Pedro Caravatto, Rodrigo Pessôa, Sabri S Sanabani, Marina B Martinez, Thais Sarian, João E Salles, Ricardo Cohen, Carla R Taddei
BACKGROUND: In recent years, studies indicate gut microbiota as an important modulator in the pathophysiology of type 2 diabetes. Environmental and genetic factors interact to control the host's intestinal microbiota, triggering metabolic disorders such as obesity and insulin resistance. OBJECTIVES: The objective of this study was to identify the fecal microbiota in adult type 2 diabetes patients and to assess changes in composition after metabolic surgery. SETTING: University Hospital of the University of São Paulo...
July 29, 2018: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
Anne-Marie Dupuy, Maëlle Plawecki, Anne-Sophie Bargnoux, Stéphanie Badiou, Martine Delage, Manuela Lotierzo, Jean-Paul Cristol
BACKGROUND: Mindray BS480©, a multi-parametric and random-access clinical chemistry instrument, is suitable for medium-sized hospital applications. Large laboratories in hospital environments require high throughput non-emergency settings that could slow routine production lines. In addition, the possibility to adapt to different methodologies is of great convenience for improving the transfer from manual to automated applications. The aim of the study is to evaluate analytical performances and to draw a comparison between analyzers for most common clinical parameters under simulated routine conditions...
July 2018: Annals of Clinical and Laboratory Science
R R Jiang, Y J Wang, X D Teng, L Xiao, H Bu, F Ye
Objective: To compare the performance of Miseq and Ion Torrent PGM platforms and library construction method for next-generation sequencing (NGS) technology for formalin-fixed and paraffin-embedded (FFPE) samples. Methods: A total of 204 FFPE cancer samples including 100 non-small cell lung cancers at the First Affiliated Hospital of Zhejiang University, and 104 colorectal cancers at West China Hospital of Sichuan University were retrospectively selected from January 2013 to December 2016. By using the same samples, DNA was extracted, and the same amount of DNA was used for library construction with the same kit, and sequenced on Miseq and Ion Torrent PGM respectively, after passing the quality control...
August 8, 2018: Zhonghua Bing Li Xue za Zhi Chinese Journal of Pathology
Vahagn C Nikolian, Aaron M Williams, Benjamin N Jacobs, Michael T Kemp, Jesse K Wilson, Michael W Mulholland, Hasan B Alam
BACKGROUND: Telemedicine in surgery holds promise for improving access and decreasing costs, but its role remains ill-defined. This pilot study was performed to investigate the safety, feasibility, and financial implications of providing postoperative care using an electronic clinic (eClinic) at a university hospital. METHODS: An easy-to-use and secure eClinic platform was constructed in Epic (Epic Systems Corporation, Verona, WA). Patients undergoing laparoscopic cholecystectomy, appendectomy, and hernia repairs on an adult acute care surgery service were enrolled in this program over an 11-month period (March 2017 to January 2018)...
October 2018: Annals of Surgery
Yi-Min Zhu, Jing-Wen Ai, Bin Xu, Peng Cui, Qi Cheng, Honglong Wu, Yi-Yi Qian, Hao-Cheng Zhang, Xian Zhou, Li Xing, Renhua Wu, Yongjun Li, Wen-Hong Zhang
BACKGROUND: Talaromyces marneffei, is an opportunistic pathogenic fungus that is most commonly reported in Southeast Asia and disseminated T.marneffei infection predominantly occurs in patients with immunodeficiency. With a potential to invade multiple organs, it can be fatal for patients if diagnosis and treatment are delayed. In current clinical practice, the diagnosis of T.marneffei infection relies heavily on tissue culture and histologic analysis, which may suffer from limited positive rate and is sometimes time consuming...
August 7, 2018: BMC Infectious Diseases
Aaisha Opel, Josephine Mansell, Alison Butler, Rhona Schwartz, Michael Fannon, Malcolm Finlay, Ross J Hunter, Richard J Schilling
Aims: We investigated safety and efficacy of a high throughput atrial fibrillation (AF) ablation service within a local non-cardiac centre compared with matched patients at the regional tertiary cardiac centre. Methods and results: Patients were consented in clinic and pre-assessed by clerical staff. Locally, other than physicians, staff had no experience of ablation and were trained with simulations. Pulmonary vein isolation (PVI) was performed with conscious sedation, on uninterrupted anticoagulation for at least 4 weeks...
July 30, 2018: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
Maurice Chan, Seok Hwee Koo, Boran Jiang, Pei Qi Lim, Thean Yen Tan
BACKGROUND: Respiratory infections are common reasons for hospital admission, and are associated with enormous economic burden due to significant morbidity and mortality. The wide spectrum of microbial agents underlying the pathology renders the diagnosis of respiratory infections challenging. Molecular diagnostics offer an advantage to the current serological and culture-based methods in terms of sensitivity, coverage, hands-on time, and time to results. OBJECTIVES: This study aimed to compare the clinical performance of three commercial kits for respiratory viral detection...
September 2018: Journal of Clinical Virology: the Official Publication of the Pan American Society for Clinical Virology
K Papier, L G Gordon, K Khosrotehrani, N Isbel, S Campbell, A Griffin, A C Green
BACKGROUND: The incidence of skin cancer in organ transplant recipients (OTRs) is very high due mainly to long-term immunosuppressive therapy. The problem is particularly severe for organ transplant recipients living in Queensland, Australia, resulting in significant mortality. OBJECTIVE: To describe the experience of the first dedicated outpatient high-throughput Transplant Skin Clinic in Queensland. METHODS: This prospective evaluation study was conducted at a newly established, outpatient transplant skin cancer surgery and surveillance clinic...
July 13, 2018: British Journal of Dermatology
W W Zhu, Z L Li
Objective: To investigate the impact of early antibiotics treatment on intestinal microbiota in preterm infants. Methods: The cohort study was performed from January 2015 to June 2015 in Neonatal Intensive Care Unit of Peking University Third Hospital. A total of 33 preterm infants were enrolled, among whom 25 were antibiotics-exposure group, and 8 were non-exposure group. Serial stool samples were collected on the first day, 14th and 30th days of life and analyzed by high-throughput sequencing. In exposure group, intestinal microbiota was also analyzed at 8 months to 1 year of age...
July 2, 2018: Zhonghua Er Ke za Zhi. Chinese Journal of Pediatrics
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