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Critical care information systems

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https://www.readbyqxmd.com/read/29159555/use-of-a-hands-free-instantaneous-closed-loop-communication-device-improves-perception-of-communication-and-workflow-integration-in-an-academic-teaching-hospital-a-pilot-study
#1
Daniel Z Fang, Teja Patil, Ilana Belitskaya-Levy, Marianne Yeung, Keith Posley, Nazima Allaudeen
Efficient and effective communication between providers is critical to quality patient care within a hospital system. Hands free communication devices (HFCD) allow instantaneous, closed-loop communication between physicians and other members of a multidisciplinary team, providing a communication advantage over traditional pager systems. HFCD have been shown to decrease emergency room interruptions, improve nursing communication, improve speed of information flow, and eliminate health care waste. We evaluated the integration of an HFCD with an existing alphanumeric paging system on an acute inpatient medicine service...
November 17, 2017: Journal of Medical Systems
https://www.readbyqxmd.com/read/29157285/map-of-biomedical-research-in-cameroon-a-documentary-review-of-approved-protocols-from-1997-to-2012
#2
Ebile Akoh Walter, Ateudjieu Jerome, Djuidje Ngounoue Marceline, Martin Ndinakie Yakum, Watcho Pierre
BACKGROUND: Over the last decade, there has been a rapid increase in biomedical research in Cameroon. However, the question of whether these research projects target major health priorities, vulnerable populations and geographic locations at risk remains to be answered. The aim of this paper is to describe the state of biomedical research in Cameroon which is a key determinant that would guide future health care policies and promote equitable access to healthcare. METHODS: A documentary review of all approved protocols (proposals) of biomedical research projects, from 1997 through 2012, at the Cameroon National Ethics Committee...
November 21, 2017: Globalization and Health
https://www.readbyqxmd.com/read/29153922/e-health-in-switzerland-the-laborious-adoption-of-the-federal-law-on-electronic-health-records-ehr-and-health-information-exchange-hie-networks
#3
Carlo De Pietro, Igor Francetic
Within the framework of a broader e-health strategy launched a decade ago, in 2015 Switzerland passed a new federal law on patients' electronic health records (EHR). The reform requires hospitals to adopt interoperable EHRs to facilitate data sharing and cooperation among healthcare providers, ultimately contributing to improvements in quality of care and efficiency in the health system. Adoption is voluntary for ambulatories and private practices, that may however be pushed towards EHRs by patients. The latter have complete discretion in the choice of the health information to share...
November 10, 2017: Health Policy
https://www.readbyqxmd.com/read/29151364/a-clinical-prediction-model-to-identify-patients-at-high-risk-of-hemodynamic-instability-in-the-pediatric-intensive-care-unit
#4
Cristhian Potes, Bryan Conroy, Minnan Xu-Wilson, Christopher Newth, David Inwald, Joseph Frassica
BACKGROUND: Early recognition and timely intervention are critical steps for the successful management of shock. The objective of this study was to develop a model to predict requirement for hemodynamic intervention in the pediatric intensive care unit (PICU); thus, clinicians can direct their care to patients likely to benefit from interventions to prevent further deterioration. METHODS: The model proposed in this study was trained on a retrospective cohort of all patients admitted to a tertiary PICU at a single center in the United States, and validated on another retrospective cohort of all patients admitted to the PICU at a single center in the United Kingdom...
November 20, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29151207/rapid-prediction-of-multi-dimensional-nmr-data-sets-using-fandas
#5
Siddarth Narasimhan, Deni Mance, Cecilia Pinto, Markus Weingarth, Alexandre M J J Bonvin, Marc Baldus
Solid-state NMR (ssNMR) can provide structural information at the most detailed level and, at the same time, is applicable in highly heterogeneous and complex molecular environments. In the last few years, ssNMR has made significant progress in uncovering structure and dynamics of proteins in their native cellular environments [1-4]. Additionally, ssNMR has proven to be useful in studying large biomolecular complexes as well as membrane proteins at the atomic level [5]. In such studies, innovative labeling schemes have become a powerful approach to tackle spectral crowding...
2018: Methods in Molecular Biology
https://www.readbyqxmd.com/read/29149864/kinetic-estimated-glomerular-filtration-rate-in-critically-ill-patients-beyond-the-acute-kidney-injury-severity-classification-system
#6
Flávio de Oliveira Marques, Saulo Aires Oliveira, Priscila Ferreira de Lima E Souza, Wandervânia Gomes Nojoza, Maiara da Silva Sena, Taynara Muniz Ferreira, Bruno Gabriele Costa, Alexandre Braga Libório
BACKGROUND: Although significant advances have been achieved in acute kidney injury (AKI) research following its classification, potential pitfalls can be identified in clinical practice. The nonsteady-state (kinetic) estimated glomerular filtration rate (KeGFR) could add clinical and prognostic information in critically ill patients beyond the current AKI classification system. METHODS: This was a retrospective analysis using data from the Multiparameter Intelligent Monitoring in Intensive Care II project...
November 18, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29140836/pyoderma-gangrenosum-a-critical-appraisal
#7
Eran Shavit, Afsaneh Alavi, R Gary Sibbald
GENERAL PURPOSE: To provide information about pyoderma gangrenosum (PG), including pathophysiology, diagnostic criteria, and treatment. TARGET AUDIENCE: This continuing education activity is intended for physicians, physician assistants, nurse practitioners, and nurses with an interest in skin and wound care. LEARNING OBJECTIVES/OUTCOMES: After participating in this educational activity, the participant should be better able to: ABSTRACT: Pyoderma gangrenosum (PG) is an uncommon cutaneous disease, presenting with recurrent painful ulcerations most commonly on the lower extremities...
December 2017: Advances in Skin & Wound Care
https://www.readbyqxmd.com/read/29138126/promoting-secondary-analysis-of-electronic-medical-records-in-china-summary-of-the-plagh-mit-critical-data-conference-and-health-datathon
#8
Peiyao Li, Chen Xie, Tom Pollard, Alistair Edward William Johnson, Desen Cao, Hongjun Kang, Hong Liang, Yuezhou Zhang, Xiaoli Liu, Yong Fan, Yuan Zhang, Wanguo Xue, Lixin Xie, Leo Anthony Celi, Zhengbo Zhang
Electronic health records (EHRs) have been widely adopted among modern hospitals to collect and track clinical data. Secondary analysis of EHRs could complement the traditional randomized control trial (RCT) research model. However, most researchers in China lack either the technical expertise or the resources needed to utilize EHRs as a resource. In addition, a climate of cross-disciplinary collaboration to gain insights from EHRs, a crucial component of a learning healthcare system, is not prevalent. To address these issues, members from the Massachusetts Institute of Technology (MIT) and the People's Liberation Army General Hospital (PLAGH) organized the first clinical data conference and health datathon in China, which provided a platform for clinicians, statisticians, and data scientists to team up and address information gaps in the intensive care unit (ICU)...
November 14, 2017: JMIR Medical Informatics
https://www.readbyqxmd.com/read/29131390/immune-function-in-critically-ill-dogs
#9
D Hoffman, J Amorim, A DeClue
BACKGROUND: People with critical illness (CI) commonly develop various forms of immune dysfunction, however, there is limited information concerning immune dysfunction in dogs with CI. HYPOTHESIS: The immune response in CI dogs differs from that of healthy dogs. ANIMALS: Immunologic variables were compared between 14 dogs with CI, defined as APPLEfast score of >20 points, admitted to the University of Missouri Veterinary Health Center Small Animal Clinic Intensive Care Unit and healthy controls (n = 15)...
November 13, 2017: Journal of Veterinary Internal Medicine
https://www.readbyqxmd.com/read/29126196/interface-information-interaction-a-narrative-review-of-design-and-functional-requirements-for-clinical-decision-support
#10
Kristen Miller, Danielle Mosby, Muge Capan, Rebecca Kowalski, Raj Ratwani, Yaman Noaiseh, Rachel Kraft, Sanford Schwartz, William S Weintraub, Ryan Arnold
Objective: Provider acceptance and associated patient outcomes are widely discussed in the evaluation of clinical decision support systems (CDSSs), but critical design criteria for tools have generally been overlooked. The objective of this work is to inform electronic health record alert optimization and clinical practice workflow by identifying, compiling, and reporting design recommendations for CDSS to support the efficient, effective, and timely delivery of high-quality care. Material and Methods: A narrative review was conducted from 2000 to 2016 in PubMed and The Journal of Human Factors and Ergonomics Society to identify papers that discussed/recommended design features of CDSSs that are associated with the success of these systems...
November 6, 2017: Journal of the American Medical Informatics Association: JAMIA
https://www.readbyqxmd.com/read/29101937/an-organization-model-to-assist-individual-physicians-scientists-and-senior-health-care-administrators-with-personal-and-professional-needs
#11
REVIEW
Tait D Shanafelt, Deborah J Lightner, Christopher R Conley, Steven P Petrou, Jarrett W Richardson, Pamela J Schroeder, William A Brown
Working as a physician, scientist, or senior health care administrator is a demanding career. Studies have demonstrated that burnout and other forms of distress are common among individuals in these professions, with potentially substantive personal and professional consequences. In addition to system-level interventions to promote well-being globally, health care organizations must provide robust support systems to assist individuals in distress. Here, we describe the 15-year experience of the Mayo Clinic Office of Staff Services (OSS) providing peer support to physicians, scientists, and senior administrators at one center...
November 2017: Mayo Clinic Proceedings
https://www.readbyqxmd.com/read/29100972/neural-and-neuroendocrine-predictors-of-pharmacological-treatment-response-in-adolescents-with-depression-a-preliminary-study
#12
Bonnie Klimes-Dougan, Melinda Westlund Schreiner, Michelle Thai, Meredith Gunlicks-Stoessel, Kristina Reigstad, Kathryn R Cullen
OBJECTIVE: Typically, about 30 to 50% of adolescents with depression fail to respond to evidence-based treatments, including antidepressant medications such as selective serotonin reuptake inhibitors (SSRIs). Efforts for identifying predictors and moderators of treatment response are needed to begin to address critical questions relevant to personalized care in adolescent depression. In this pilot study, we aim to identify biological predictors of response to antidepressant treatment...
February 2, 2018: Progress in Neuro-psychopharmacology & Biological Psychiatry
https://www.readbyqxmd.com/read/29100141/dynamic-modeling-approaches-to-characterize-the-functioning-of-health-systems-a-systematic-review-of-the-literature
#13
Angela Y Chang, Osondu Ogbuoji, Rifat Atun, Stéphane Verguet
Universal Health Coverage (UHC) is one of the targets for the United Nations Sustainable Development Goal 3. The impetus for UHC has led to an increased demand for time-sensitive tools to enhance our knowledge of how health systems function and to evaluate impact of system interventions. We define the field of "health system modeling" (HSM) as an area of research where dynamic mathematical models can be designed in order to describe, predict, and quantitatively capture the functioning of health systems. HSM can be used to explore the dynamic relationships among different system components, including organizational design, financing and other resources (such as investments in resources and supply chain management systems) - what we call "inputs" - on access, coverage, and quality of care - what we call "outputs", toward improved health system "outcomes", namely increased levels and fairer distributions of population health and financial risk protection...
September 22, 2017: Social Science & Medicine
https://www.readbyqxmd.com/read/29092868/patients-outcomes-after-acute-respiratory-failure-a-qualitative-study-with-the-promis-framework
#14
Michelle N Eakin, Yashika Patel, Pedro Mendez-Tellez, Victor D Dinglas, Dale M Needham, Alison E Turnbull
BACKGROUND: As mortality rates for patients treated in intensive care units decrease, greater understanding of the impact of critical illness on patients' well-being is needed. OBJECTIVE: To describe the survivorship experience of patients who had acute respiratory failure by using the Patient Reported Outcomes Measurement Information System (PROMIS) framework. METHODS: A total of 48 adult patients who had acute respiratory failure completed at least 1 semistructured telephone-based interview between 5 and 18 months after their stay in the intensive care unit...
November 2017: American Journal of Critical Care: An Official Publication, American Association of Critical-Care Nurses
https://www.readbyqxmd.com/read/29091509/a-person-centered-registry-based-learning-health-system-for-palliative-care-a-path-to-coproducing-better-outcomes-experience-value-and-science
#15
Arif H Kamal, Kathryn B Kirkland, Diane E Meier, Tamara S Morgan, Eugene C Nelson, Steven Z Pantilat
BACKGROUND: Palliative care offers an approach to the care of people with serious illness that focuses on quality of life and aligning care with individual and family goals, and values in the context of what is medically achievable. OBJECTIVE: Measurement of the impact of palliative care is critical for determining what works for which patients in what settings, to learn, improve care, and ensure access to high value care for people with serious illness. METHODS: A learning health system that includes patients and families partnering with clinicians and care teams, is directly linked to a registry to support networks for improvement and research, and offers an ideal framework for measuring what matters to a range of stakeholders interested in improving care for this population...
November 1, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/29080720/measuring-maternal-mortality-and-morbidity-in-canada
#16
REVIEW
Jocelynn L Cook, Mina Majd, Jennifer Blake, Jon Yosef Barrett, Sylvie Bouvet, Patricia Janssen, Marian Knight, Sarka Lisonkova, Heather Scott, Suzanne Tough, Tom Wong
Maternal mortality and severe maternal morbidity are devastating for women, their families, and care providers. International efforts have been made to develop and to implement data collection, management, and surveillance systems that capture pregnancy-related information that can be assessed and used to improve health and system outcomes. At present, Canada does not have a national enquiry process to review maternal deaths, severe morbidity, and near misses, and has not set targets for maternal mortality reduction...
November 2017: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
https://www.readbyqxmd.com/read/29065147/developing-citizen-report-cards-for-primary-health-care-in-low-and-middle-income-countries-results-from-cognitive-interviews-in-rural-tajikistan
#17
Sebastian Bauhoff, Lila Rabinovich, Lauren A Mayer
Citizen report cards on health care providers have been identified as a potential means to increase citizen engagement, provider accountability and health systems performance. Research in high-income settings indicates that the wording, presentation and display of performance information are critical to achieve these goals. However, there are limited insights on developing effective report card designs for middle- and low-income settings. We conducted cognitive interviews to assess consumers' understanding, interpretation of and preferences for displaying information for a health care report card in rural Tajikistan...
2017: PloS One
https://www.readbyqxmd.com/read/29065024/learning-from-patients-why-continuity-matters
#18
Sevinj Asgarova, Mark MacKenzie, Joanna Bates
PURPOSE: Patient continuity, described as the student participating in the provision of comprehensive care of patients over time, may offer particular opportunities for student learning. The aim of this study was to describe how students experience patient continuity and what they learn from it. METHOD: An interpretive phenomenological study was conducted between 2015 and 2016. Seventeen fourth-year medical students were interviewed following a longitudinal clinical placement and asked to describe their experiences of patient continuity and what they learned from each experience...
November 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/29063601/community-based-palliative-care-and-advance-care-planning-documentation-evidence-from-a-multispecialty-group
#19
Ming Tai-Seale, Yan Yang, Ellis Dillon, Sharon Tapper, Steve Lai, Peter Yu, Heather Allore, Christine Ritchie
BACKGROUND/OBJECTIVES: With the growing public demand for access to critical health data across care settings, it is essential that advance care planning (ACP) information be included in the electronic health record (EHR) so that multiple clinicians can access it and understand individuals' preferences for end-of-life care. Community-based palliative care programs often incorporate ACP services. This study examined whether a community-based palliative care program is associated with digitally extractable ACP documentation in the EHR...
October 24, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/29061621/detection-and-management-of-familial-hypercholesterolaemia-in-primary-care-in-australia-protocol-for-a-pragmatic-cluster-intervention-study-with-pre-post-intervention-comparisons
#20
Diane E Arnold-Reed, Tom Brett, Lakkhina Troeung, Alistair Vickery, Jacquie Garton-Smith, Damon Bell, Jing Pang, Tegan Grace, Caroline Bulsara, Ian Li, Max Bulsara, Gerald F Watts
INTRODUCTION: Familial hypercholesterolaemia (FH), an autosomal dominant disorder of lipid metabolism, results in accelerated onset of atherosclerosis if left untreated. Lifelong treatment with diet, lifestyle modifications and statins enable a normal lifespan for most patients. Early diagnosis is critical. This protocol trials a primary care-based model of care (MoC) to improve detection and management of FH. METHODS AND ANALYSIS: Pragmatic cluster intervention study with pre-post intervention comparisons in Australian general practices...
October 22, 2017: BMJ Open
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