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https://www.readbyqxmd.com/read/28637582/principles-of-capacity-management-applied-in-the-mental-health-context
#1
Kathryn Zeitz, Darryl Watson
Objective The aim of the paper was to describe a suite of capacity management principles that have been applied in the mental health setting that resulted in a significant reduction in time spent in two emergency departments (ED) and improved throughput.Methods The project consisted of a multifocal change approach over three phases that included: (1) the implementation of a suite of fundamental capacity management activities led by the service and clinical director; (2) a targeted Winter Demand Plan supported by McKinsey and Co...
June 22, 2017: Australian Health Review: a Publication of the Australian Hospital Association
https://www.readbyqxmd.com/read/28631129/optimizing-the-deep-brain-stimulation-care-pathway-in-patients-with-parkinson-s-disease
#2
N J Thomas, P Mertens, T Danaila, G Polo, H Klinger, E Broussolle, S Thobois
Management of Parkinson's disease (PD) using deep brain stimulation (DBS) requires complex care in specialized, multidisciplinary centers. A well-organized, efficient patient flow is crucial to ensure that eligible patients can quickly access DBS. Delays or inefficiencies in patient care may impact a center's ability to meet demand, creating a capacity bottleneck. Analysis of the current practices within a center may help identify areas for improvement. After external audit of the DBS workflow of the Lyon Neurological Hospital and comparison with other European centers, manageable steps were suggested to restructure the care pathway...
June 19, 2017: Journal of Neurology
https://www.readbyqxmd.com/read/28624270/implementation-and-evaluation-of-a-navigator-role-to-improve-emergency-department-throughput
#3
Paul Fulbrook, Melanie Jessup, Frances Kinnear
BACKGROUND: Emergency department overcrowding impacts patients, staff, and quality of care, and there is government pressure to optimize throughput and reduce waiting times. One solution for improving patient flow is the emerging 'navigator' role: a nurse that supports staff in care delivery; facilitating efficient and timely patient movement through the emergency department. METHODS: A 20-week project was implemented to evaluate an emergency department nurse navigator role...
June 14, 2017: Australasian Emergency Nursing Journal: AENJ
https://www.readbyqxmd.com/read/28605399/measurement-error-in-intensive-care-unit-length-of-stay-estimates-due-to-patient-flow
#4
Michael O Harhay, Sarah J Ratcliffe, Scott D Halpern
Clinical endpoints measured in terms of duration, such as intensive care unit (ICU) length of stay (LOS), are widely used in randomized clinical trials (RCTs) and observational research. In analyses of patient-level data from a recent RCT, in which ICU LOS was the primary endpoint, and in administrative data, we show that additional ICU time is often accrued by patients after they are deemed ready for discharge. This "immutable" time (which cannot plausibly be altered by interventions under study) varies by day, week, and year, adding on average one-third of a day to total LOS...
June 9, 2017: American Journal of Epidemiology
https://www.readbyqxmd.com/read/28602101/expert-panel-on-practice-patterns-in-the-management-of-cow-s-milk-protein-allergy-and-associated-economic-burden-of-disease-on-health-service-in-turkey
#5
Bulent Enis Sekerel, Oznur Seyhun
AIMS: To evaluate practice patterns in the management of cow's milk protein allergy (CMPA) and associated economic burden of disease on health service in Turkey. MATERIALS AND METHODS: This study was based on experts' views on the practice patterns in management of CMPA manifesting with either proctocolitis or eczema symptoms and, thereby, aimed to estimate economic burden of CMPA. Practice patterns were determined via patient flow charts developed by experts using the modified Delphi method for CMPA presented with proctocolitis and eczema...
June 22, 2017: Journal of Medical Economics
https://www.readbyqxmd.com/read/28593802/the-effect-on-the-patient-flow-in-a-local-health-care-after-implementing-reverse-triage-in-a-primary-care-emergency-department-a-longitudinal-follow-up-study
#6
Timo Kauppila, Katri Seppänen, Juho Mattila, Johanna Kaartinen
OBJECTIVE: Reverse triage means that patients who are not considered to be in need of medical services are not placed on the doctor's list in an emergency department (ED) but are sent, after face-to-face evaluation by a triage nurse, to a more appropriate health care unit. It is not known how an abrupt application of such reverse triage in a combined primary care ED alters the demand for doctors' services in collaborative parts of the health care system. DESIGN: An observational study...
June 8, 2017: Scandinavian Journal of Primary Health Care
https://www.readbyqxmd.com/read/28582315/application-of-clinical-intelligence-to-streamline-care-in-aortic-emergencies
#7
Susan K Moats, B Jeffery Richard
This article discusses the lessons learned by an interdisciplinary team in a large metropolitan specialty hospital during the implementation of the Code Aorta protocol for aortic emergencies and the subsequent application of technological enhancements to improve data transfer. Aortic dissections require rapid diagnosis and surgical treatment; thus, in order to optimize patient outcomes, clinicians must be accessible, data must be readily available, and proper prompts and notifications must be made to alert and ready teams...
June 3, 2017: Computers, Informatics, Nursing: CIN
https://www.readbyqxmd.com/read/28578738/shaping-quality-through-vision-structure-and-monitoring-of-performance-and-quality-indicators-impact-story-from-the-quebec-trauma-network
#8
Catherine Truchon, Lynne Moore, Amina Belcaid, Julien Clément, Nathalie Trudelle, Marie-Andrée Ulysse, Benoît Grolleau, Jacinthe Clusiau, Danielle Lévesque, Michèle de Guise
OBJECTIVES: The Quebec Trauma Care Continuum (TCC) was initiated in 1991 with the objective of providing accessible, continuous, efficient, and high quality services for all injury cases in the province. METHODS: The TCC design relied on three key components: (i) the designation of a network of acute care and rehabilitation facilities with specific mandates and responsibilities; (ii) the elaboration of transfer protocols, standing agreements, and governing structures to ensure fluid and optimal patient flow; and (iii) the close monitoring of several indicators to facilitate the continuous evaluation and improvement of the network...
June 5, 2017: International Journal of Technology Assessment in Health Care
https://www.readbyqxmd.com/read/28576806/improving-patient-flow-setting-up-of-an-ambulatory-care-unit-in-nevill-hall-hospital-using-the-core-role-of-the-chief-registrar
#9
S Akhtar, M Brouns, D Wales, C Ward
No abstract text is available yet for this article.
June 2017: Clinical Medicine: Journal of the Royal College of Physicians of London
https://www.readbyqxmd.com/read/28571519/using-lean-manufacturing-principles-to-evaluate-wait-times-for-hiv-positive-patients-in-an-urban-clinic-in-kenya
#10
Aliza Monroe-Wise, Elizabeth Reisner, Kenneth Sherr, David Ojakaa, Lilian Mbau, Paul Kisia, Samuel Muhula, Carey Farquhar
As human immunodeficiency virus (HIV) treatment programs expand in Africa, delivery systems must be strengthened to support patient retention. Clinic characteristics may affect retention, but a relationship between clinic flow and attrition is not established. This project characterized HIV patient experience and flow in an urban Kenyan clinic to understand how these may affect retention. We used Toyota's lean manufacturing principles to guide data collection and analysis. Clinic flow was evaluated using value stream mapping and time and motion techniques...
January 1, 2017: International Journal of STD & AIDS
https://www.readbyqxmd.com/read/28560670/flow-cytometric-methods-for-circulating-tumor-cell-isolation-and-molecular-analysis
#11
Neha Bhagwat, Erica L Carpenter
Circulating tumor cells provide a non-invasive source of tumor material that can be valuable at all stages of disease management, including screening and early diagnosis, monitoring response to therapy, identifying therapeutic targets, and assessing development of drug resistance. Cells isolated from the blood of cancer patients can be used for phenotypic analysis, tumor genotyping, transcriptional profiling, as well as for ex vivo culture of isolated cells. There are a variety of novel technologies currently being developed for the detection and analysis of rare cells in circulation of cancer patients...
2017: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/28537908/increased-expression-of-irf8-in-tumor-cells-inhibits-the-generation-of-th17-cells-and-predicts-unfavorable-survival-of-diffuse-large-b-cell-lymphoma-patients
#12
Weijie Zhong, Xin Xu, Zhigang Zhu, Qinghua Du, Hong Du, Li Yang, Yanying Ling, Huabao Xiong, Qingshan Li
The immunological pathogenesis of diffuse large B cell lymphoma (DLBCL) remains elusive. Searching for new prognostic markers of DLBCL is a crucial focal point for clinical scientists. The aim of the present study was to examine the prognostic value of interferon regulatory factor 8 (IRF8) expression and its effect on the development of Th17 cells in the tumor microenvironment of DLBCL patients. Flow cytometry, immunohistochemistry, and quantitative real-time PCR were used to detect the distribution of Th17 cells and related cytokines and IRF8 in tumor tissues from DLBCL patients...
May 8, 2017: Oncotarget
https://www.readbyqxmd.com/read/28534558/-proposing-a-physiological-model-for-emergency-department-operating-principles-classification-of-overcrowding-and-guidelines-for-redesign
#13
M Herrera Carranza, F Aguado Correa, N Padilla Garrido, F López Camacho
The operation of Emergency Departments (ED) is determined by demand, their own organizational structures and the connection to other medical care levels. When these elements are not simultaneous, it hinders patient flow and decreases capacity, making it necessary to employ a systemic approach to the chain of emergency care as a single operational entity. With this theoretical orientation, we suggest a conceptual model similar to the physiological cardiac output, in which the preload is the demand, the contractile or flow pump is the organizational structure, the afterload is the hospital, the pre-ED valve is primary care and outpatient emergencies, and the post-ED valve is the diagnostic support services and the specialist consultants...
April 30, 2017: Anales del Sistema Sanitario de Navarra
https://www.readbyqxmd.com/read/28530457/-patient-turnover-in-a-multidisciplinary-emergency-department
#14
Csaba Varga, Zsuzsanna Lelovics, Viktor Soós, Tibor Oláh
INTRODUCTION: More than twenty emergency departments were opened across Hungary in the past years. Data deficiency on patient flow, trends and lack of knowledge of indicators could raise numerous logistical and organisational problems. AIM: Collection, analysis and provision of data to facilitate successful operations of emergency medical care services. METHOD: During a three-year period investigated, at the multidisciplinary Emergency Department of "Moritz Kaposi" Teaching Hospital, data on patient flow (n = 106,203), epidemiology, triage and international classification of diseases were analysed...
May 2017: Orvosi Hetilap
https://www.readbyqxmd.com/read/28527640/influences-on-patient-satisfaction-among-patients-who-use-emergency-departments-frequently-for-pain-related-complaints
#15
Patricia Newcomb, Marian Wilson, Ralph Baine, Terence McCarthy, Nicholas Penny, Caroline Nixon, Justin Orren
INTRODUCTION: The primary purpose of this study was to assess relationships between opioid prescribing practices, patient and ED attributes, and patient satisfaction ratings of nursing and physician care among patients with high utilization of the emergency department for pain relief. METHODS: A retrospective cohort study was conducted to examine 305 individual patient satisfaction surveys from users with high ED utilization for pain complaints. Responses were compared with an age-matched control group (n = 305) of nonfrequent ED users...
May 17, 2017: Journal of Emergency Nursing: JEN: Official Publication of the Emergency Department Nurses Association
https://www.readbyqxmd.com/read/28504772/patient-flow-in-acute-medical-units-a-design-approach-to-flow-improvement
#16
L de Almeida, E Matthews
No abstract text is available yet for this article.
December 2016: Journal of the Royal College of Physicians of Edinburgh
https://www.readbyqxmd.com/read/28494806/what-makes-weekend-allied-health-services-effective-and-cost-effective-or-not-in-acute-medical-and-surgical-wards-perceptions-of-medical-nursing-and-allied-health-workers
#17
Lisa O'Brien, Deb Mitchell, Elizabeth H Skinner, Romi Haas, Marcelle Ghaly, Fiona McDermott, Kerry May, Terry Haines
BACKGROUND: There is strong public support for acute hospital services to move to genuine 7-day models, including access to multidisciplinary team assessment. This study aimed to identify factors that might enable an effective and cost-effective weekend allied health services on acute hospital wards. METHODS: This qualitative study included 22 focus groups within acute wards with a weekend allied health service and 11 telephone interviews with weekend service providers...
May 12, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28494481/enhanced-hip-fracture-management-use-of-statistical-methods-and-dataset-to-evaluate-a-fractured-neck-of-femur-fast-track-pathway-pilot-study
#18
Nigel Gilchrist, Kristian Dalzell, Scott Pearson, Gary Hooper, Kit Hoeben, Jeremy Hickling, John McKie, Ma Yi, Sandra Chamberlain, Caroline McCullough, Marc Gutenstein
The increasing elderly population and subsequent rise in total hip fracture(s) in this group means more effective management strategies are necessary to improve efficiency. We have changed our patient care strategy from the emergency department (ED), acute orthopaedic wards, operating theatre, post-operation and rehabilitation, and called it Fracture Neck of Femur Fast Track Pathway. All clinical data and actions were captured, integrated and displayed on a weekly basis using 'signalfromnoise' (SFN) software...
May 12, 2017: New Zealand Medical Journal
https://www.readbyqxmd.com/read/28487459/patient-flow-within-uk-emergency-departments-a-systematic-review-of-the-use-of-computer-simulation-modelling-methods
#19
Syed Mohiuddin, John Busby, Jelena Savović, Alison Richards, Kate Northstone, William Hollingworth, Jenny L Donovan, Christos Vasilakis
OBJECTIVES: Overcrowding in the emergency department (ED) is common in the UK as in other countries worldwide. Computer simulation is one approach used for understanding the causes of ED overcrowding and assessing the likely impact of changes to the delivery of emergency care. However, little is known about the usefulness of computer simulation for analysis of ED patient flow. We undertook a systematic review to investigate the different computer simulation methods and their contribution for analysis of patient flow within EDs in the UK...
May 9, 2017: BMJ Open
https://www.readbyqxmd.com/read/28485885/hospital-occupancy-and-discharge-strategies-a-simulation-based-study
#20
S Qin, C Thompson, T Bogomolov, D Ward, P Hakendorf
BACKGROUND: Increasing demand for hospital services has resulted in more arrivals to emergency department (ED), increased admissions, and, quite often, access block and ED congestion, along with patients' dissatisfaction. Cost constraints limit an increase in the number of hospital beds, so alternative solutions need to be explored. AIMS: The aims of this study were to propose and test different discharge strategies which, potentially, could reduce occupancy rates in the hospital, thereby improving patient flow and minimising frequency and duration of congestion episodes...
May 9, 2017: Internal Medicine Journal
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