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Service, quality, efficiency

Susan B Roman, Allison Matthews-Wilson, Patricia Dickinson, Danielle Chenard, Steven C Rogers
Emergency departments (EDs) across North America have become a safety net for patients seeking mental health (MH) services. The prevalence of families seeking treatment of children in MH crisis has become a national emergency. To address MH access and improve quality and efficient management of children with MH conditions, the authors describe ED projects targeting this vulnerable population. Five North American health care systems volunteered to feature projects that seek to reduce ED visits and/or improve the care of MH patients: Allina Health, Nationwide Children's Hospital, Children's Hospital of Eastern Ontario, Connecticut Children's Medical Center, and Rhode Island Hospital...
July 2018: Child and Adolescent Psychiatric Clinics of North America
Aled Jones, Ben Hannigan, Michael Coffey, Alan Simpson
CONTEXT: In response to political and social factors over the last sixty years mental health systems internationally have endeavoured to transfer the delivery of care from hospitals into community settings. As a result, there has been increased emphasis on the need for better quality care planning and care coordination between hospital services, community services and patients and their informal carers. The aim of this systematic review of international research is to explore which interventions have proved more or less effective in promoting personalized, recovery oriented care planning and coordination for community mental health service users...
2018: PloS One
Liwen Cui, Xiaolei Xie, Zuojun Shen
There have been rapidly growing applications using machine learning models for predictive analytics in Electronic Health Records (EHR) to improve the quality of hospital services and the efficiency of healthcare resource utilization. A fundamental and crucial step in developing such models is to convert medical codes in EHR to feature vectors. These medical codes are used to represent diagnoses or procedures. Their vector representations have a tremendous impact on the performance of machine learning models...
June 18, 2018: Journal of Biomedical Informatics
Jeong-Im Ryu, Kisook Kim
AIM: To investigate differences in work satisfaction and quality of nursing services between nurses from the nursing care integration service and general nursing units in Korea. BACKGROUND: The nursing care integration service was recently introduced in Korea to improve patient health outcomes through the provision of high quality nursing services and to relieve the caregiving burden of patients' families. METHODS: In this cross-sectional study, data were collected from a convenience sample of 116 and 156 nurses working in nursing care integration service and general units, respectively...
June 20, 2018: Journal of Nursing Management
Giulio Pioli, Chiara Bendini, Paolo Pignedoli, Andrea Giusti, David Marsh
A high proportion of patients with fragility fracture, mainly hip fracture, have a variable degree of comorbidity and show some degree of dependence in basic or more complex activities of daily living. Evaluating these patents following the geriatric concept of frailty, about one third of hip fracture patients may be categorised as frail with high risk of poor outcomes and prolonged length of stay, one third as not frail, and about one third with an intermediate condition. Due to the high vulnerability, combined with the hip fracture event and surgical repair procedures, a multidisciplinary approach that includes geriatric competencies becomes essential to improve short and long-term outcomes after hip fracture...
April 20, 2018: Injury
Jürg Blaser
Challenges of Digital Medicine Abstract. Digitization is increasingly covering more and more sectors, including medicine. To ensure medical operation 365 × 24 hours, progressively more human and financial resources are necessary. The transformation of patient histories from paper into electronic patient records focused initially on documentation. Today, hospital information systems are increasingly used as a platform for the communication of all professionals involved in the patient process - in Switzerland, however, so far without providing patients direct access to their data...
June 2018: Praxis
S Zoëga, S Gunnarsdóttir, D B Gordon
Aims To gain an understanding of the concept of quality pain management (QPM) in the hospital setting, and to define the concept. Methods A concept evaluation based on the method by Morse and colleagues was done. The literature was searched according to selected key words in five databases. Over 5000 articles were found but data were limited to 37 articles directly related to both quality and pain management in adults in the hospital setting, and published in peer-reviewed journals or by an official organization...
December 29, 2017: Scandinavian Journal of Pain
Dina Watterson, Kerrie Walter, Lisa O'Brien, Desiree Terrill, Kathleen Philip, Indi Swan, Lisa Somerville
Objective: To explore cost-efficiency, safety and acceptability of trans-disciplinary advanced allied health (AH) practitioners for acute adult general medicine inpatients. Design: Quasi-experimental feasibility study. Setting: Three acute general medical units in an Australian urban hospital. Participants: Two hundred and fifty-six acute hospital inpatients. Main Outcome Measures: Cost-efficiency measures included AH service utilization and length of stay (LOS)...
June 15, 2018: International Journal for Quality in Health Care
Julie MacInnes, Liz Williams
AimThe aim of this integrative review is to determine the effectiveness of integrated heart failure (HF) care in terms of patient-, service- and resource-related outcomes, and to determine what model or characteristics of integrated care work best, for whom and in what contexts. BACKGROUND: Integration of health and social care services is a significant driver in the development of better and more cost-effective health and social care systems in Europe and developed countries. As high users of health and social care services, considerable attention has been paid to the care of people with long-term conditions...
June 18, 2018: Primary Health Care Research & Development
Diane R M Somlo, Nelson P Repenning, Abeel A Mangi
BACKGROUND: Contemporary reimbursement systems allow hospitals to maintain profitability by offering procedural services. However, increasing procedural volume can be met with structural inefficiencies that in turn cause delays, worse patient outcomes, and increased cost. METHODS: A multidisciplinary team assessed operations and outcomes at the Heart and Vascular Center at Yale New Haven Hospital, a tertiary academic medical center. Data were analyzed retrospectively to assess delays in transferring patients between care environments, patient outcomes, and cost...
June 13, 2018: Annals of Thoracic Surgery
T A M Datema, K G Roper, S Cognat, M D Saad, L Oskam, V Dolmazon, M F M Engelberts, P Hessels, P R Klatser
OBJECTIVES: To introduce the Laboratory Quality Stepwise Implementation (LQSI) tool and provide data about its roll-out, usage and effectiveness in assisting laboratories with quality improvement. METHODS: The LQSI tool, a freely available stepwise guide, was developed by WHO to assist laboratories in efficiently implementing a quality management system. RESULTS: Since the tool's launch in 2014, it has been accessed by 116,431 unique users from 195 of 206 listed states...
June 15, 2018: Tropical Medicine & International Health: TM & IH
Eric J Bruns, Alyssa N Hook, Elizabeth M Parker, Isabella Esposito, April Sather, Ryan M Parigoris, Aaron R Lyon, Kelly L Hyde
BACKGROUND: Electronic health records (EHRs) have been widely proposed as a mechanism for improving health care quality. However, rigorous research on the impact of EHR systems on behavioral health service delivery is scant, especially for children and adolescents. OBJECTIVE: The current study evaluated the usability of an EHR developed to support the implementation of the Wraparound care coordination model for children and youth with complex behavioral health needs, and impact of the EHR on service processes, fidelity, and proximal outcomes...
June 14, 2018: Journal of Medical Internet Research
J A Michel-Macarty, M A Murillo-Escobar, R M López-Gutiérrez, C Cruz-Hernández, L Cardoza-Avendaño
BACKGROUND AND OBJECTIVES: Currently, telemedicine is levered upon the improvement in communication network technology such as Body Area Sensor Networks (BASN) to provided biomedicine solutions. Nevertheless, information security is an important issue since biomedical data is exchanged through insecure channels, which exposes private information that can be intercepted by malicious intruder. Therefore, secure communication protocols for multiuser networks in telemedicine applications are a big challenge...
August 2018: Computer Methods and Programs in Biomedicine
Xinqiang Ji, Yun Fang, Jing Liu
Diagnosis-related groups (DRGs) have been receiving increasing attention in health service research in China. In the present study, we used the 2014 Beijing-Diagnosis Related Groups (BJ-DRGs) to evaluate the inpatient service performance of the clinical subspecialty "major operation of the digestive system" of a cancer specialist hospital.The research hospital is one of 16 public municipal hospitals overseen by the Beijing Health Bureau ("16 hospitals"). Discharge data collected between 2008 and 2015 were drawn from the front pages of the medical records of these hospitals...
June 2018: Medicine (Baltimore)
Mohammad F Alharbi
Change management studies have emphasized the significance of an organization's readiness for change and transformation and have recommended strategies to affect change. Organizational readiness for change is a multi-faceted, multi-level, and multi-dimensional activity; its most important aspect is organizational members' willingness to accept and implement change because ignoring the human factors may result in resistance and failure. Through its National Transformation Program 2020, the Saudi Arabian government is attempting to effect radical changes in the structure and function of its health-care system to achieve quality care and effective service delivery...
May 2018: International Journal of Health Sciences
Cheng Ye, Joseph Coco, Anna Epishova, Chen Hajaj, Henry Bogardus, Laurie Novak, Joshua Denny, Yevgeniy Vorobeychik, Thomas Lasko, Bradley Malin, Daniel Fabbri
Crowdsourcing services like Amazon Mechanical Turk allow researchers to ask questions to crowds of workers and quickly receive high quality labeled responses. However, crowds drawn from the general public are not suitable for labeling sensitive and complex data sets, such as medical records, due to various concerns. Major challenges in building and deploying a crowdsourcing system for medical data include, but are not limited to: managing access rights to sensitive data and ensuring data privacy controls are enforced; identifying workers with the necessary expertise to analyze complex information; and efficiently retrieving relevant information in massive data sets...
2018: AMIA Summits on Translational Science Proceedings
Mykhailo V Golubchykov, Nataliia M Orlova, Inna V Bielikova
OBJECTIVE: Introduction: Implementation of new methods of information support of managerial decision-making should ensure of the effective health system reform and create conditions for improving the quality of operational management, reasonable planning of medical care and increasing the efficiency of the use of system resources. Reforming of Medical Statistics Service of Ukraine should be considered only in the context of the reform of the entire health system. The aim: This work is an analysis of the current situation and justification of the main directions of reforming of Medical Statistics Service of Ukraine...
2018: Wiadomości Lekarskie: Organ Polskiego Towarzystwa Lekarskiego
Stanislav G Saksonov, Tetiana S Gruzeva, Oksana P Vitovska
OBJECTIVE: Introduction: The effectiveness and efficiency of the medical sector workforce directly depend on health of medical professionals. Scientific literature pays considerable attention to the health of surgeons, physicians, obstetricians, gynecologists, infectionists and dentists paying very little, if any, attention to health problems of ophthalmologists. This study is intended to bridge this gap. The aim at revealing the current situation and characteristics of health status of ophthalmologists using the results of sociological research and identifying health problems of the respondents in order to determine reliable preventive measures...
2018: Wiadomości Lekarskie: Organ Polskiego Towarzystwa Lekarskiego
Phuc Chau, Jitae Shin, Jaehoon Paul Jeong
Recently, the wireless sensor network paradigm is shifting toward research aimed at enabling the robust delivery of multimedia content. A challenge is to deliver multimedia content with predefined levels of Quality of Service (QoS) under resource constraints such as bandwidth, energy, and delay. In this paper, we propose a distributed systematic network coding (DSNC) scheme for reliable multimedia content uploading over wireless multimedia sensor networks, in which a large number of multimedia sensor nodes upload their own content to a sink through a cluster head node...
June 5, 2018: Sensors
Sylvi Thun, Vidar Halsteinli, Lise Løvseth
BACKGROUND: It has been shown that a recently defined stressor, 'illegitimate tasks', has negative effects on employees' work motivation and health. Better understanding of the illegitimate tasks undertaken by physicians might contribute to a more resource-efficient division of labour within the health care system, with beneficial effects on organisational economics and employee performance. We aimed to investigate the prevalence of unreasonable illegitimate tasks, their associations with workplace variables and their impact on health, in particular sickness presenteeism...
June 5, 2018: BMC Health Services Research
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