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https://www.readbyqxmd.com/read/28794660/a-renal-colic-fast-track-pathway-to-improve-waiting-times-and-outcomes-for-patients-presenting-to-the-emergency-department
#1
Omar Al Kadhi, Kate Manley, Madhavi Natarajan, Valmiki Lutchmedial, Abbi Forsyth, Kate Tabrett, Jonathan Betteridge, William Finch, Heinrich Hollis
INTRODUCTION: Renal colic is commonly encountered in the emergency department (ED). We validated a fast track renal colic (FTRC) initiative to decrease patient waiting times and streamline patient flow. METHOD: The FTRC pathway was devised according to the National Institute for Health and Care Excellence clinical summary criteria for the management of patients with suspected renal colic. ED triage nurses use the pathway to identify patients with likely renal colic suitable for fast track to analgesia, investigation and management...
2017: Open Access Emergency Medicine: OAEM
https://www.readbyqxmd.com/read/28790024/hierarchical-medical-system-based-on-big-data-and-mobile-internet-a-new-strategic-choice-in-health-care
#2
Yaogang Wang, Li Sun, Jie Hou
China is setting up a hierarchical medical system to solve the problems of biased resource allocation and high patient flows to large hospitals. The development of big data and mobile Internet technology provides a new perspective for the establishment of hierarchical medical system. This viewpoint discusses the challenges with the hierarchical medical system in China and how big data and mobile Internet can be used to mitigate these challenges.
August 8, 2017: JMIR Medical Informatics
https://www.readbyqxmd.com/read/28755763/reliability-of-triage-nurses-and-emergency-physicians-for-the-interpretation-of-the-c-3po-rule-for-head-trauma-in-children
#3
Jocelyn Gravel, Serge Gouin, Annie Canuel, Benoît Mâsse
INTRODUCTION: The C-3PO rule has been validated for use by emergency physicians to identify young children at risk of skull fracture following head trauma. The use of the rule by triage nurses could improve patient flow in the emergency department. OBJECTIVES: To evaluate the interobserver agreement of triage nurses and emergency physicians in the interpretation of the C-3PO rule in a pediatric emergency department. METHODS: This was a prospective observational study performed in a consecutive sample of children visiting a single emergency department...
July 26, 2017: Journal of Emergency Nursing: JEN: Official Publication of the Emergency Department Nurses Association
https://www.readbyqxmd.com/read/28750906/quantitative-metrics-for-evaluating-the-phased-roll-out-of-clinical-information-systems
#4
David Wong, Nicolas Wu, Peter Watkinson
OBJECTIVES: We introduce a novel quantitative approach for evaluating the order of roll-out during phased introduction of clinical information systems. Such roll-outs are associated with unavoidable risk due to patients transferring between clinical areas using both the old and new systems. METHODS: We proposed a simple graphical model of patient flow through a hospital. Using a simple instance of the model, we showed how a roll-out order can be generated by minimising the flow of patients from the new system to the old system...
September 2017: International Journal of Medical Informatics
https://www.readbyqxmd.com/read/28750022/determinants-of-operative-time-in-thyroid-surgery-a-prospective-multicenter-study-of-3454-thyroidectomies
#5
Arnaud Patoir, Cécile Payet, Jean-Louis Peix, Cyrille Colin, Léa Pascal, Jean-Louis Kraimps, Fabrice Menegaux, François Pattou, Frédéric Sebag, Sandrine Touzet, Stéphanie Bourdy, Jean-Christophe Lifante, Antoine Duclos
OBJECTIVE: To identify the determinants of operative time for thyroidectomy and quantify the relative influence of preoperative and intra-operative factors. BACKGROUND: Anticipation of operative time is key to avoid both waste of hospital resources and dissatisfaction of the surgical staff. Having an accurate and anticipated planning would allow a rationalized operating room use and may improve patient flow and staffing level. METHODS: We conducted a prospective, cross-sectional study between April 2008 and December 2009...
2017: PloS One
https://www.readbyqxmd.com/read/28748771/acute-care-referral-systems-in-liberia-transfer-and-referral-capabilities-in-a-low-income-country
#6
Jimin Kim, Maria Barreix, Christine Babcock, Corey B Bills
Introduction Following two decades of armed conflict in Liberia, over 95% of health care facilities were partially or completely destroyed. Although the Liberian health system has undergone significant rehabilitation, one particular weakness is the lack of organized systems for referral and prehospital care. Acute care referral systems are a critical component of effective health care delivery and have led to improved quality of care and patient outcomes. Problem This study aimed to characterize the referral and transfer systems in the largest county of Liberia...
July 27, 2017: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/28738050/intralesional-therapy-consensus-statements-for-best-practices-in-administration-from-the-melanoma-nursing-initiative%C3%A2
#7
Virginia Seery
BACKGROUND: Talimogene laherparepvec (T-VEC) is the first intralesional therapy for melanoma approved by the U.S. Food and Drug Administration. This oncolytic viral immunotherapy has improved outcomes for patients with locoregional recurrent melanoma and is showing promise in combination with systemic therapies. 
. OBJECTIVES: This article aims to provide oncology nurses with expert guidance on best practices in incorporating intralesional therapy for patients diagnosed with melanoma in practice...
August 1, 2017: Clinical Journal of Oncology Nursing
https://www.readbyqxmd.com/read/28734583/kidney-transplantation-from-hla-incompatible-live-donors-efficiency-and-outcome-of-32-patients-after-desensitisation
#8
Constantino Fernández, María Calvo, Natacha Leite, Andrés López, Tamara Ferreiro, Roi Ribera, Rocío Seijo, Ángel Alonso
Desensitisation is a procedure undergone by the recipient of a kidney transplant from a donor who is cross-match positive. The aim of this study was to present the outcomes from our hospital of kidney transplant recipients from HLA-incompatible live donors after desensitisation. We studied 32 patients aged 46±14 years with a mean fluorescence intensity (MFI) versus class I HLA of 7979±4089 and 6825±4182 MFI versus class II and relative intensity scale (RIS) of 8.9±7.6. The complement-dependent cytotoxicity (CDC) cross-matching test was positive in 18 patients, flow cytometry was positive in 7 patients and donor-specific antibodies (DEA) were detected in 7...
July 19, 2017: Nefrología: Publicación Oficial de la Sociedad Española Nefrologia
https://www.readbyqxmd.com/read/28726594/crowding-karenina-and-complexity-patient-flow-in-evolving-health-care-ecosystems
#9
David A Petrie
No abstract text is available yet for this article.
July 20, 2017: CJEM
https://www.readbyqxmd.com/read/28723845/lean-six-sigma-techniques-to-improve-ophthalmology-clinic-efficiency
#10
Thomas A Ciulla, Mohan V Tatikonda, Yehya A ElMaraghi, Rehan M Hussain, Amanda L Hill, Julie M Clary, Eyas Hattab
PURPOSE: Ophthalmologists serve an increasing volume of a growing elderly population undergoing increasingly complex outpatient medical care, including extensive diagnostic testing and treatment. The resulting prolonged patient visit times ("patient flow times") limit quality, patient and employee satisfaction, and represent waste. Lean Six Sigma process improvement was used in a vitreoretinal practice to decrease patient flow time, demonstrating that this approach can yield significant improvement in health care...
July 18, 2017: Retina
https://www.readbyqxmd.com/read/28722784/the-universal-collaborative-dynamic-model-of-specialist-and-advanced-nursing-and-midwifery-practice-a-way-forward
#11
Laserina O'Connor, Mary Casey, Rita Smith, Gerard Michael Fealy, Denise O' Brien, Denise O'Leary, Diarmuid Stokes, Martin S McNamara, Mary Ellen Glasgow, Andrew Cashin
BACKGROUND: There is a sizable body of empirical literature supporting the unique contributions of specialist and advanced practice roles to health care. However, there is very little international evidence to inform the integration of a future model for advanced or specialist practice in the Irish health care system. AIM: The aim of this study was to inform and guide the development of a future model of specialist and advanced nursing and midwifery practice. DESIGN: A qualitative study was conducted to initiate this important area of inquiry...
July 19, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28718257/risk-factors-for-heat-related-deaths-during-the-june-2015-heat-wave-in-karachi-pakistan
#12
Syed Ghazanfar Saleem, Tehreem Ansari, Ashraf Shamshad Ali, Sara Fatima, Mariam Hassan Rizvi, Muhammad Abdul Samad
BACKGROUND: Mortality as a consequence of heat related illness is a public health concern. Emergency department (ED) experiences increased patients' flow and decreased survival as a consequence of heat stroke during the episodes of heat wave. The present study was conducted to identify the risk factors for mortality among victims of heat wave (17th - 23rd June), 2015 evaluated in the Emergency Department of The Indus Hospital (TIH), Karachi. METHODS: In this cross-sectional study data was retrospectively collected...
April 2017: Journal of Ayub Medical College, Abbottabad: JAMC
https://www.readbyqxmd.com/read/28716795/the-magnitude-of-and-factors-associated-with-loss-to-follow-up-among-patients-treated-for-sexually-transmitted-infections-a-multilevel-analysis
#13
Mache Tsadik, Yemane Berhane, Alemayehu Worku, Wondwossen Terefe
OBJECTIVES: The loss to follow-up (LTFU) among patients attending care for sexually transmitted infections (STIs) in Sub-Saharan Africa is a major barrier to achieving the goals of the STI prevention and control programme. The objective of this study was to investigate individual- and facility-level factors associated with LTFU among patients treated for STIs in Ethiopia. METHODS: A prospective cohort study was conducted among patients attending care for STIs in selected facilities from January to June 2015 in the Tigray region of Ethiopia...
July 17, 2017: BMJ Open
https://www.readbyqxmd.com/read/28714834/adjusting-patients-streaming-initiated-by-a-wait-time-threshold-in-emergency-department-for-minimizing-opportunity-cost
#14
Byungjoon B J Kim, Theodore R Delbridge, Dawn B Kendrick
Purpose Two different systems for streaming patients were considered to improve efficiency measures such as waiting times (WTs) and length of stay (LOS) for a current emergency department (ED). A typical fast track area (FTA) and a fast track with a wait time threshold (FTW) were designed and compared effectiveness measures from the perspective of total opportunity cost of all patients' WTs in the ED. The paper aims to discuss these issues. Design/methodology/approach This retrospective case study used computerized ED patient arrival to discharge time logs (between July 1, 2009 and June 30, 2010) to build computer simulation models for the FTA and fast track with wait time threshold systems...
July 10, 2017: International Journal of Health Care Quality Assurance
https://www.readbyqxmd.com/read/28714485/health-care-waste-management-practice-in-health-care-institutions-of-nepal
#15
H D Joshi, T Acharya, R Ayer, P Dhakal, K B Karki, M Dhimal
BACKGROUND: Medical waste is considered as a major public health hazard. In a developing country like Nepal, there is much concern about the management practice of medical waste. This study aimed to assess Health Care Waste Management practice among Health Care Institutions in Nepal. METHODS: A cross sectional study was carried out between July 2012 to June 2013 in 62 different Health Care Institutions, selected from stratified proportionate random sampling technique from all administrative regions of Nepal...
January 2017: Journal of Nepal Health Research Council
https://www.readbyqxmd.com/read/28707992/transitional-care-services-a-quality-and-safety-process-improvement-program-in-neurosurgery
#16
Faith C Robertson, Jessica L Logsdon, Hormuzdiyar H Dasenbrock, Sandra C Yan, Siobhan M Raftery, Timothy R Smith, William B Gormley
OBJECTIVE Readmissions increasingly serve as a metric of hospital performance, inviting quality improvement initiatives in both medicine and surgery. However, few readmission reduction programs have targeted surgical patient populations. The objective of this study was to establish a transitional care program (TCP) with the goal of decreasing length of stay (LOS), improving discharge efficiency, and reducing readmissions of neurosurgical patients by optimizing patient education and postdischarge surveillance...
July 14, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28707707/evidence-for-capitation-reform-in-a-new-rural-cooperative-medical-scheme-in-pudong-new-area-shanghai-a-longitudinal-study
#17
Yanmei Wang, Zhiqun Shu, Jianjun Gu, Xiaoming Sun, Limei Jing, Jie Bai, Xuan Huang, Jiquan Lou, Qunfang Zhang, Ming Li
Currently, China has been experiencing rapid growth of medical costs, serious waste of medical resources, increasing disease burden for residents, and a medical insurance fund deficit. Therefore, an urgent problem that needs to be solved is to choose a rational payment for the insurance system. To empirically evaluate the long-term effects of capitation reform in a New Rural Cooperative Medical Scheme in Pudong New Area, we collected and analysed data regarding financing, fund operation, medical service cost, and medical care-seeking behaviour from 2011 to 2015, a duration that includes data before and after reform...
July 14, 2017: International Journal of Health Planning and Management
https://www.readbyqxmd.com/read/28704269/the-impact-of-medical-specialist-staffing-on-emergency-department-patient-flow-and-satisfaction
#18
M Christien van der Linden, Roeline A Y de Beaufort, Sven A G Meylaerts, Crispijn L van den Brand, Naomi van der Linden
OBJECTIVE: The aim of this study was to describe the impact of additional medical specialists, non-emergency physicians (non-EPs), performing direct supervision or a combination of direct and indirect supervision at an EP-led emergency department (ED), on patient flow and satisfaction. PATIENTS AND METHODS: An observational, cross-sectional, three-part study was carried out including staff surveys (n=379), a before and after 16-week data collection using data of visits during the peak hours (n=5270), and patient questionnaires during 1 week before the pilot and during week 5 of the pilot...
July 12, 2017: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/28702185/potential-cost-savings-by-minimisation-of-blood-sample-delays-on-care-decision-making-in-urgent-care-services
#19
David M S Bodansky, Sophie E Lumley, Rudrajoy Chakraborty, Dhanasekaran Mani, James Hodson, Mike T Hallissey, Olga N Tucker
BACKGROUND: Timely availability of blood sample results for interpretation affects planning and delivery of patient care from initial assessment in Accident and Emergency (A&E) departments. MATERIALS AND METHODS: Rates of, and reasons for, rejected blood samples submitted from all clinical areas over one month were evaluated. Haemoglobin (Hb) represented haematology and potassium (K(+)), biochemistry. A prospective observational study evaluated the methodology of sample collection and impact on utility...
August 2017: Annals of Medicine and Surgery
https://www.readbyqxmd.com/read/28701232/the-three-paradoxes-of-patient-flow-an-explanatory-case-study
#20
Sara A Kreindler
BACKGROUND: Health systems in many jurisdictions struggle to reduce Emergency Department congestion and improve patient flow across the continuum of care. Flow is often described as a systemic issue requiring a "system approach"; however, the implications of this idea remain poorly understood. Focusing on a Canadian regional health system whose flow problems have been particularly intractable, this study sought to determine what system-level flaws impede healthcare organizations from improving flow...
July 12, 2017: BMC Health Services Research
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