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Healthcare systems engineering

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https://www.readbyqxmd.com/read/29310475/human-factors-and-usability-engineering-in-the-development-of-smt-101-for-the-treatment-of-pulmonary-arterial-hypertension
#1
Peter Noymer, Assaf Shaked, Kay Newell
BACKGROUND: SMT-101, a novel, proprietary, water-resistant wearable infusion pump prefilled with a preset dosage of treprostinil, was designed to address many of the administration-related shortcomings of existing parenteral therapy for pulmonary arterial hypertension (PAH). The objective of the human factors (HF) program was to demonstrate that the SMT-101 system is safe and effective when used by patients with PAH, their caregivers, or healthcare providers. METHODS: The HF program for SMT-101 consisted of 8 studies (148 participants): an ethnographic study, an online survey of patients with PAH, 4 formative studies, a study of the instructions for use (IFU), and a summative study for validation...
January 9, 2018: Expert Opinion on Drug Delivery
https://www.readbyqxmd.com/read/29303417/evaluation-of-detergent-free-and-detergent-based-methods-for-decellularization-of-murine-skin
#2
Ali Farrokhi, Mohammadreza Pakyari, Layla Nabai, Amir Pourghadiri, Ryan Hartwell, Reza B Jalili, Aziz Ghahary
Acute and chronic wounds contribute to increased morbidity and mortality in affected people and impose significant financial burdens on healthcare systems. For these challenging wounds, Acellular Dermal Matrices (ADMs) have been used as a biological wound coverage. Unlike engineered dermal matrices, ADMs are prepared through the removal of cells from skin, while preserving the extracellular matrix structure and function. In this study, our primary objective was to develop a detergent-free method of decellularization of the skin to mitigate chemical stress on matrix molecules...
January 5, 2018: Tissue Engineering. Part A
https://www.readbyqxmd.com/read/29302918/in-vivo-evaluation-of-bacterial-cellulose-acrylic-acid-wound-dressing-hydrogel-containing-keratinocytes-and-fibroblasts-for-burn-wounds
#3
Najwa Mohamad, Evelyn Yun Xi Loh, Mh Busra Fauzi, Min Hwei Ng, Mohd Cairul Iqbal Mohd Amin
The healing of wounds, including those from burns, currently exerts a burden on healthcare systems worldwide. Hydrogels are widely used as wound dressings and in the field of tissue engineering. The popularity of bacterial cellulose-based hydrogels has increased owing to their biocompatibility. Previous study demonstrated that bacterial cellulose/acrylic acid (BC/AA) hydrogel increased the healing rate of burn wound. This in vivo study using athymic mice has extended the use of BC/AA hydrogel by the addition of human epidermal keratinocytes and human dermal fibroblasts...
January 4, 2018: Drug Delivery and Translational Research
https://www.readbyqxmd.com/read/29300992/learning-from-high-risk-industries-may-not-be-straightforward-a-qualitative-study-of-the-hierarchy-of-risk-controls-approach-in-healthcare
#4
Elisa G Liberati, Mohammad Farhad Peerally, Mary Dixon-Woods
Objective: Though healthcare is often exhorted to learn from 'high-reliability' industries, adopting tools and techniques from those sectors may not be straightforward. We sought to examine the hierarchies of risk controls approach, used in high-risk industries to rank interventions according to supposed effectiveness in reducing risk, and widely advocated as appropriate for healthcare. Design: Classification of risk controls proposed by clinical teams following proactive detection of hazards in their clinical systems...
December 27, 2017: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/29290097/challenges-in-developing-mucosal-vaccine-and-antibodies-against-infectious-diarrhea-in-children
#5
REVIEW
Daisuke Tokuhara
Infectious diarrhea in children can be life-threatening and imposes a large economic burden on healthcare systems, therefore more effective prophylactic and therapeutic drugs are needed urgently. Because most of the pathogens responsible for childhood diarrhea infect the gastrointestinal mucosa, providing protective immunity at the mucosal surface is an ideal way to control pathogen invasion and toxic activity. Mucosal (e.g., oral, nasal) vaccines are superior to systemic (subcutaneous or intramuscular) vaccination for conferring both mucosal and systemic pathogen-specific immune responses...
December 31, 2017: Pediatrics International: Official Journal of the Japan Pediatric Society
https://www.readbyqxmd.com/read/29289415/insights-from-the-design-and-implementation-of-a-single-entry-model-of-referral-for-total-joint-replacement-surgery-critical-success-factors-and-unanticipated-consequences
#6
Zaheed Damani, Gail MacKean, Eric Bohm, Tom Noseworthy, Jenney Meng Han Wang, Brie DeMone, Brock Wright, Deborah A Marshall
BACKGROUND: Single-entry models (SEMs) in healthcare allow patients to see the next-available provider and have been shown to improve waiting times, access and patient flow for preference-sensitive, scheduled services. The Winnipeg Central Intake Service (WCIS) for hip and knee replacement surgery was implemented to improve access in the Winnipeg Regional Health Authority. This paper describes the system's design/implementation; successes, challenges, and unanticipated consequences. METHODS: On two occasions, during and following implementation, we interviewed all members of the WCIS project team, including processing engineers, waiting list coordinators, administrators and policy-makers regarding their experiences...
November 4, 2017: Health Policy
https://www.readbyqxmd.com/read/29250306/a-3d-scan-model-and-thermal-image-data-fusion-algorithms-for-3d-thermography-in-medicine
#7
Adam Chromy, Ondrej Klima
Objectives: At present, medical thermal imaging is still considered a mere qualitative tool enabling us to distinguish between but lacking the ability to quantify the physiological and nonphysiological states of the body. Such a capability would, however, facilitate solving the problem of medical quantification, whose presence currently manifests itself within the entire healthcare system. Methods: A generally applicable method to enhance captured 3D spatial data carrying temperature-related information is presented; in this context, all equations required for other data fusions are derived...
2017: Journal of Healthcare Engineering
https://www.readbyqxmd.com/read/29196866/reducing-bottlenecks-to-improve-the-efficiency-of-the-lung-cancer-care-delivery-process-a-process-engineering-modeling-approach-to-patient-centered-care
#8
Feng Ju, Hyo Kyung Lee, Xinhua Yu, Nicholas R Faris, Fedoria Rugless, Shan Jiang, Jingshan Li, Raymond U Osarogiagbon
The process of lung cancer care from initial lesion detection to treatment is complex, involving multiple steps, each introducing the potential for substantial delays. Identifying the steps with the greatest delays enables a focused effort to improve the timeliness of care-delivery, without sacrificing quality. We retrospectively reviewed clinical events from initial detection, through histologic diagnosis, radiologic and invasive staging, and medical clearance, to surgery for all patients who had an attempted resection of a suspected lung cancer in a community healthcare system...
December 1, 2017: Journal of Medical Systems
https://www.readbyqxmd.com/read/29190036/devices-for-preventing-percutaneous-exposure-injuries-caused-by-needles-in-healthcare-personnel
#9
REVIEW
Viraj K Reddy, Marie-Claude Lavoie, Jos H Verbeek, Manisha Pahwa
BACKGROUND: Percutaneous exposure injuries from devices used for blood collection or for injections expose healthcare workers to the risk of blood borne infections such as hepatitis B and C, and human immunodeficiency virus (HIV). Safety features such as shields or retractable needles can possibly contribute to the prevention of these injuries and it is important to evaluate their effectiveness. OBJECTIVES: To determine the benefits and harms of safety medical devices aiming to prevent percutaneous exposure injuries caused by needles in healthcare personnel versus no intervention or alternative interventions...
November 14, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29148314/clinical-decision-support-systems-in-hospital-care-using-ubiquitous-devices-current-issues-and-challenges
#10
Mirza Mansoor Baig, Hamid GholamHosseini, Aasia A Moqeem, Farhaan Mirza, Maria Lindén
Supporting clinicians in decision making using advanced technologies has been an active research area in biomedical engineering during the past years. Among a wide range of ubiquitous systems, smartphone applications have been increasingly developed in healthcare settings to help clinicians as well as patients. Today, many smartphone applications, from basic data analysis to advanced patient monitoring, are available to clinicians and patients. Such applications are now increasingly integrating into healthcare for clinical decision support, and therefore, concerns around accuracy, stability, and dependency of these applications are rising...
November 1, 2017: Health Informatics Journal
https://www.readbyqxmd.com/read/29140281/non-contact-sensor-for-long-term-continuous-vital-signs-monitoring-a-review-on-intelligent-phased-array-doppler-sensor-design
#11
REVIEW
Travis Hall, Donald Y C Lie, Tam Q Nguyen, Jill C Mayeda, Paul E Lie, Jerry Lopez, Ron E Banister
It has been the dream of many scientists and engineers to realize a non-contact remote sensing system that can perform continuous, accurate and long-term monitoring of human vital signs as we have seen in many Sci-Fi movies. Having an intelligible sensor system that can measure and record key vital signs (such as heart rates and respiration rates) remotely and continuously without touching the patients, for example, can be an invaluable tool for physicians who need to make rapid life-and-death decisions. Such a sensor system can also effectively help physicians and patients making better informed decisions when patients' long-term vital signs data is available...
November 15, 2017: Sensors
https://www.readbyqxmd.com/read/29127389/high-brightness-laser-imaging-with-tunable-speckle-reduction-enabled-by-electroactive-micro-optic-diffusers
#12
Hamid Farrokhi, Thazhe Madam Rohith, Jeeranan Boonruangkan, Seunghwoi Han, Hyunwoong Kim, Seung-Woo Kim, Young-Jin Kim
High coherence of lasers is desirable in high-speed, high-resolution, and wide-field imaging. However, it also causes unavoidable background speckle noise thus degrades the image quality in traditional microscopy and more significantly in interferometric quantitative phase imaging (QPI). QPI utilizes optical interference for high-precision measurement of the optical properties where the speckle can severely distort the information. To overcome this, we demonstrated a light source system having a wide tunability in the spatial coherence over 43% by controlling the illumination angle, scatterer's size, and the rotational speed of an electroactive-polymer rotational micro-optic diffuser...
November 10, 2017: Scientific Reports
https://www.readbyqxmd.com/read/29115019/cell-laden-composite-suture-threads-for-repairing-damaged-tendons
#13
Raquel Costa-Almeida, Rui M A Domingues, Afsoon Fallahi, Huseyin Avci, Iman K Yazdi, Mohsen Akbari, Rui L Reis, Ali Tamayol, Manuela E Gomes, Ali Khademhosseini
Tendons have limited regenerative capacity due to their low cellularity and hypovascular nature, which results in poor clinical outcomes of presently used therapies. As tendon injuries are often observed in active adults, it poses an increasing socio-economic burden on healthcare systems. Currently, suture threads are used during surgical repair to anchor the tissue graft or to connect injured ends. Here, we created composite suture threads coated with a layer of cell-laden hydrogel that can be used for bridging the injured tissue aiming at tendon regeneration...
November 8, 2017: Journal of Tissue Engineering and Regenerative Medicine
https://www.readbyqxmd.com/read/29050810/how-to-not-detonate-the-bomb-the-case-of-the-italian-national-health-service
#14
G La Torre, A Federici
Why is Italy one of the world's highest ranked for ability and quality of healthcare in relationship to the resources invested? The last decade has been characterized by many Italian Regions with Recovery Plans, whose main focus was on short-term issues with a high impact on healthcare costs. Italy is now leaving this phase and at the regional level there will be an increase of new hirings in the healthcare sectors, as stated by the Ministry of Health. There is a large amount of scientific literature that supports the role of factors such as lifestyles, diet and genetics as the base of population health...
October 16, 2017: Public Health
https://www.readbyqxmd.com/read/29027496/optimizing-usability-and-signal-capture-a-proactive-risk-assessment-for-the-implementation-of-a-wireless-vital-sign-monitoring-system
#15
Rebecca Kowalski, Muge Capan, Peter Lodato, Danielle Mosby, Tamekia Thomas, Ryan Arnold, Kristen Miller
Wearable vital sign monitors are a promising step towards optimal patient surveillance, providing continuous data to allow for early detection and treatment of patient deterioration. However, as wearable monitors become more widely adopted in healthcare, there is a corresponding need to carefully design the implementation of these tools to promote their integration into clinical workflows and defend against potential misuse and patient harm. Prior to the roll-out of these monitors, our multidisciplinary team of clinicians, clinical engineers, information technologists and research investigators conducted a modified Healthcare Failure Mode and Effect Analysis (HFMEA), a proactive evaluation of potential problems which could be encountered in the use of a wireless vital signs monitoring system...
October 13, 2017: Journal of Medical Engineering & Technology
https://www.readbyqxmd.com/read/29025843/preparing-the-prescription-a-review-of-the-aim-and-measurement-of-social-referral-programmes
#16
Emily S Rempel, Emma N Wilson, Hannah Durrant, Julie Barnett
OBJECTIVE: Our aim is to review, and qualitatively evaluate, the aims and measures of social referral programmes. Our first objective is to identify the aims of social referral initiatives. Our second objective is to identify the measures used to evaluate whether the aims of social referral were met. DESIGN: Literature review. BACKGROUND: Social referral programmes, also called social prescribing and emergency case referral, link primary and secondary healthcare with community services, often under the guise of decreasing health system costs...
October 12, 2017: BMJ Open
https://www.readbyqxmd.com/read/28980365/technical-rationality-and-the-decentring-of-patients-and-care-delivery-a-critique-of-unavoidable-in-the-context-of-patient-harm
#17
Marie Hutchinson, Debra Jackson, Stacey Wilson
In recent decades, debate on the quality and safety of healthcare has been dominated by a measure and manage administrative rationality. More recently, this rationality has been overlaid by ideas from human factors, ergonomics and systems engineering. Little critical attention has been given in the nursing literature to how risk of harm is understood and actioned, or how patients can be subjectified and marginalised through these discourses. The problem of assuring safety for particular patient groups, and the dominance of technical forms of rationality, has seen the word 'unavoidable' used in connection with intractable forms of patient harm...
October 4, 2017: Nursing Inquiry
https://www.readbyqxmd.com/read/28972519/the-journey-to-become-a-health-literate-organization-a-snapshot-of-health-system-improvement
#18
Cindy Brach
A health literate health care organization is one that makes it easy for people to navigate, understand, and use information and services to take care of their health. This chapter explores the journey that a growing number of organizations are taking to become health literate. Health literacy improvement has increasingly been viewed as a systems issue, one that moves beyond siloed efforts by recognizing that action is required on multiple levels. To help operationalize the shift to a systems perspective, members of the U...
2017: Studies in Health Technology and Informatics
https://www.readbyqxmd.com/read/28972409/endoscope-i-an-innovation-in-mobile-endoscopic-technology-transforming-the-delivery-of-patient-care-in-otolaryngology
#19
N Mistry, C Coulson, A George
Digital and mobile device technology in healthcare is a growing market. The introduction of the endoscope-i, the world's first endoscopic mobile imaging system, allows the acquisition of high definition images of the ear, nose and throat (ENT). The system combines the e-i Pro camera app with a bespoke engineered endoscope-i adaptor which fits securely onto the iPhone or iPod touch. Endoscopic examination forms a salient aspect of the ENT work-up. The endoscope-i therefore provides a mobile and compact alternative to the existing bulky endoscopic systems currently in use which often restrict the clinician to the clinic setting...
October 17, 2017: Expert Review of Medical Devices
https://www.readbyqxmd.com/read/28971416/vhmentor-an-ontology-supported-mobile-agent-system-for-pervasive-health-care-monitoring
#20
Stella C Christopoulou, Theodore Kotsilieris, Ioannis Anagnostopoulos, Christos-Nikolaos Anagnostopoulos, Phivos Mylonas
Healthcare provision is a set of activities that demands the collaboration of several stakeholders (e.g. physicians, nurses, managers, patients etc.) who hold distinct expertise and responsibilities. In addition, medical knowledge is diversely located and often shared under no central coordination and supervision authority, while medical data flows remain mostly passive regarding the way data is delivered to both clinicians and patients. In this paper, we propose the implementation of a virtual health Mentor (vhMentor) which stands as a dedicated ontology schema and FIPA compliant agent system...
2017: Advances in Experimental Medicine and Biology
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