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https://www.readbyqxmd.com/read/29764613/the-joint-use-of-resilience-engineering-and-lean-production-for-work-system-design-a-study-in-healthcare
#1
Caroline Brum Rosso, Tarcisio Abreu Saurin
Although lean production (LP) has been increasingly adopted in healthcare systems, its benefits often fall short of expectations. This might be partially due to the failure of lean to account for the complexity of healthcare. This paper discusses the joint use of principles of LP and resilience engineering (RE), which is an approach for system design inspired by complexity science. Thus, a framework for supporting the design of socio-technical systems, which combines insights from LP and RE, was developed and tested in a system involving a patient flow from an emergency department to an intensive care unit...
September 2018: Applied Ergonomics
https://www.readbyqxmd.com/read/29763977/transforming-care-to-evidence-based-practice-with-scripted-messages-an-improvement-project-for-pain-management-in-outpatient-surgical-patients
#2
Lanell M Bellury, Karen Mullinax, Judi Mozingo, Berta Dantzler, Nancy McGee
BACKGROUND: Outpatient surgeries are common and most patients experience pain postoperatively requiring nursing attention to pain management. Scripting, recommended for consistent, targeted communication to improve patient satisfaction, has limited evidence to support its use. AIMS: To explore the effect of scripted messages on self-reported pain control and patient satisfaction with care in outpatient surgical patients. METHODS: A retrospective medical record review pre- and postintervention evaluated a pain management scripted message delivered at two time points (preoperatively and postoperatively)...
May 15, 2018: Worldviews on Evidence-based Nursing
https://www.readbyqxmd.com/read/29753874/simulation-of-patient-flow-in-multiple-healthcare-units-using-process-and-data-mining-techniques-for-model-identification
#3
Sergey V Kovalchuk, Anastasia A Funkner, Oleg G Metsker, Aleksey N Yakovlev
INTRODUCTION: An approach to building a hybrid simulation of patient flow is introduced with a combination of data-driven methods for automation of model identification. The approach is described with a conceptual framework and basic methods for combination of different techniques. The implementation of the proposed approach for simulation of the acute coronary syndrome (ACS) was developed and used in an experimental study. METHODS: A combination of data, text, process mining techniques, and machine learning approaches for the analysis of electronic health records (EHRs) with discrete-event simulation (DES) and queueing theory for the simulation of patient flow was proposed...
May 10, 2018: Journal of Biomedical Informatics
https://www.readbyqxmd.com/read/29751798/clinic-flow-for-sti-hiv-and-tb-patients-in-an-urban-infectious-disease-clinic-offering-point-of-care-testing-services-in-durban-south-africa
#4
Katrina J Stime, Nigel Garrett, Yukteshwar Sookrajh, Jienchi Dorward, Ntuthu Dlamini, Ayo Olowolagba, Monisha Sharma, Ruanne V Barnabas, Paul K Drain
BACKGROUND: Many clinics in Southern Africa have long waiting times. The implementation of point-of-care (POC) tests to accelerate diagnosis and improve clinical management in resource-limited settings may improve or worsen clinic flow and waiting times. The objective of this study was to describe clinic flow with special emphasis on the impact of POC testing at a large urban public healthcare clinic in Durban, South Africa. METHODS: We used time and motion methods to directly observe patients and practitioners...
May 11, 2018: BMC Health Services Research
https://www.readbyqxmd.com/read/29748230/senior-doctor-triage-sdt-a-qualitative-study-of-clinicians-views-on-senior-doctors-involvement-in-triage-and-early-assessment-of-emergency-patients
#5
Maysam Ali Abdulwahid, Janette Turner, Suzanne M Mason
INTRODUCTION: Despite the focus during the last decade on introducing interventions such as senior doctor initial assessment or senior doctor triage (SDT) to reduce emergency department (ED) crowding, there has been little attempt to identify the views of emergency healthcare professionals on such interventions. The aim of this study was to gain an understanding of SDT from the perspective of emergency hospital staff. A secondary aim of this study was to develop a definition of SDT based on the interview findings and the available literature on this process...
May 10, 2018: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/29742036/emergency-department-telepsychiatry-service-model-for-a-rural-regional-health-system-the-first-steps
#6
James D Meyer, Alastair J S McKean, Rebecca N Blegen, Bart M Demaerschalk
BACKGROUND: Emergency departments (EDs) have recognized an increasing number of patients presenting with mental health (MH) concerns. This trend imposes greater demands upon EDs already operating at capacity. Many ED providers do not feel they are optimally prepared to provide the necessary MH care. One consideration in response to this dilemma is to use advanced telemedicine technology for psychiatric consultation. INTRODUCTION: We examined a rural- and community-based health system operating 21 EDs, none of which has direct access to psychiatric consultation...
May 9, 2018: Telemedicine Journal and E-health: the Official Journal of the American Telemedicine Association
https://www.readbyqxmd.com/read/29738300/wound-centres-how-do-we-obtain-high-quality-the-ewma-wound-centre-endorsement-project
#7
Finn Gottrup, Andrea Pokorná, Julie Bjerregaard, Hubert Vuagnat
OBJECTIVE: Different types of multidisciplinary concepts for treating non-healing wounds have been developed. However, there is insufficient evidence on the quality of multidisciplinary wound centres, and a limited number of evaluation systems have so far been developed. The lack of an international wound centre evaluation/certification system is the basis for the European Wound Management Association (EWMA) Wound Centre Endorsement Project. The project aims to describe the minimum requirements for a wound management centre...
May 2, 2018: Journal of Wound Care
https://www.readbyqxmd.com/read/29730093/adverse-events-and-satisfaction-with-use-of-intranasal-midazolam-for-emergency-department-procedures-in-children
#8
Laurie Malia, V Matt Laurich, Jesse J Sturm
PURPOSE: Procedural sedation is commonly performed in the emergency department (ED). Having safe and fast means of providing sedation and anxiolysis to children is important for the child's tolerance of the procedure, parent satisfaction and efficient patient flow in the ED. OBJECTIVE: To evaluate fasting times associated with the administration of intranasal midazolam (INM) and associated complications. Secondary objectives included assessing provider and caregiver satisfaction scores...
April 30, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29697806/decreasing-triage-time-effects-of-implementing-a-step-wise-esi-algorithm-in-an-ehr
#9
Stephen Villa, Ellen J Weber, Steven Polevoi, Christopher Fee, Andrew Maruoka, Tina Quon
Objectives: To determine if adapting a widely-used triage scale into a computerized algorithm in an electronic health record (EHR) shortens emergency department (ED) triage time. Design: Before-and-after quasi-experimental study. Setting: Urban, tertiary care hospital ED. Participants: Consecutive adult patient visits between July 2011 and June 2013. Intervention: A step-wise algorithm, based on the Emergency Severity Index (ESI-5) was programmed into the triage module of a commercial EHR...
April 25, 2018: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/29695603/intermediate-catheter-placement-distal-to-the-cerebral-aneurysm-during-flow-diversion-embolization-with-the-surpass-device
#10
Osman Melih Topcuoglu, Anil Arat, Ahmet Peker, Basar Sarikaya
PURPOSE: We present the preliminary angiographic and clinical results of the combined utilization of an AXS Catalyst 5 (Cat5) distal access catheter and a Surpass flow diverter (SFD) for the endovascular treatment of intracranial aneurysms. MATERIALS AND METHODS: Interventional neuroradiology case records were evaluated retrospectively to identify patients treated with an SFD in combination with Cat5. Demographic data, technical success, location of the catheter tip, aneurysm occlusion rate, and procedure-related morbidity and mortality were noted...
April 25, 2018: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/29689261/developing-a-mobile-health-application-to-assist-with-clinic-flow-documentation-billing-and-research-in-a-specialty-clinic
#11
REVIEW
Joseph E Zeman, Patrick S Moon, Aaron B Holley, Michael J McMahon
In specialty clinics, a staff physician is often required to direct patient flow through the clinic and performs all documentation for coding/billing. In response to the workload created by increased patient volume, many specialty clinics have implemented protocols for both disease management and coordinating clinic flow. In this article, we review the literature on using mobile technology to assist with patient care, clinic flow, disease management and documentation/billing. We also describe the development and implementation of a mobile application in our pulmonary clinic designed to automate patient flow, assist the physician in documentation/billing and gather research data including review of initial user data and lessons learned...
April 21, 2018: Chest
https://www.readbyqxmd.com/read/29677989/paflochar-an-innovating-approach-to-characterise-patient-flows-in-myocardial-infarction
#12
Jessica Pinaire, Jérôme Azé, Sandra Bringay, Pascal Poncelet, Christophe Genolini, Paul Landais
A better knowledge of patient flows would improve decision making in health planning. In this article, we propose a method to characterise patients flows and also to highlight profiles of care pathways considering times and costs. From medico-administrative data, we extracted spatio-temporal patterns. Then, we clustered time between hospitalisations and cost trajectories in order to identify profiles of change over time. This approach may support renewed management strategies.
2018: Studies in Health Technology and Informatics
https://www.readbyqxmd.com/read/29673317/budget-impact-model-of-mydrane%C3%A2-a-new-intracameral-injectable-used-for-intra-operative-mydriasis-from-a-uk-hospital-perspective
#13
Keith Davey, Bernard Chang, Christine Purslow, Emilie Clay, Anne-Lise Vataire
BACKGROUND: During cataract surgery, maintaining an adequate degree of mydriasis throughout the entire operation is critical to allow for visualisation of the capsulorhexis and the crystalline lens. Good anaesthesia is also essential for safe intraocular surgery. Mydrane® is a new injectable intracameral solution containing two mydriatics (tropicamide 0.02% and phenylephrine 0.31%) and one anaesthetic (lidocaine 1%) that was developed as an alternative to the conventional topical pre-operative mydriatics used in cataract surgery...
April 19, 2018: BMC Ophthalmology
https://www.readbyqxmd.com/read/29670110/tumor-associated-macrophages-promote-progression-and-the-warburg-effect-via-ccl18-nf-kb-vcam-1-pathway-in-pancreatic-ductal-adenocarcinoma
#14
Huilin Ye, Quanbo Zhou, Shangyou Zheng, Guolin Li, Qing Lin, Lusheng Wei, Zhiqiang Fu, Bin Zhang, Yimin Liu, Zhihua Li, Rufu Chen
Tumor-associated macrophages (TAMs) are frequently found near pancreatic cancer cells, but it is uncertain whether they are involved in pancreatic cancer progression and the Warburg effect. Here, we show that CCL18 secreted by TAMs facilitates malignant progression and induced a glycolytic phenotype in pancreatic cancer, partially owing to paracrine induction of VCAM-1 in pancreatic cancer cells. Reciprocally, VCAM-1-induced lactate production from pancreatic cancer cells with enhanced aerobic glycolysis activates macrophages to a TAM-like phenotype, forming a positive feedback loop...
April 18, 2018: Cell Death & Disease
https://www.readbyqxmd.com/read/29661692/hospital-ambulatory-medicine-a-leading-strategy-for-internal-medicine-in-europe
#15
Xavier Corbella, Vasco Barreto, Stefano Bassetti, Monica Bivol, Pietro Castellino, Evert-Jan de Kruijf, Francesco Dentali, Mine Durusu-Tanriöver, Carmen Fierbinţeanu-Braticevici, Thomas Hanslik, Radovan Hojs, Soňa Kiňová, Leonid Lazebnik, Evija Livčāne, Matthias Raspe, Luis Campos
Addressing the current collision course between growing healthcare demands, rising costs and limited resources is an extremely complex challenge for most healthcare systems worldwide. Given the consensus that this critical reality is unsustainable from staff, consumer, and financial perspectives, our aim was to describe the official position and approach of the Working Group on Professional Issues and Quality of Care of the European Federation of Internal Medicine (EFIM), for encouraging internists to lead a thorough reengineering of hospital operational procedures by the implementation of innovative hospital ambulatory care strategies...
April 13, 2018: European Journal of Internal Medicine
https://www.readbyqxmd.com/read/29643086/better-patient-flow-in-cardiac-and-thoracic-surgery-could-save-%C3%A2-45m-a-year-in-england
#16
Nigel Hawkes
No abstract text is available yet for this article.
April 11, 2018: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/29642339/re-standardized-process-to-improve-patient-flow-from-the-emergency-room-to-the-operating-room-for-pediatric-patients-with-testicular-torsion
#17
Douglas A Canning
No abstract text is available yet for this article.
April 2018: Journal of Urology
https://www.readbyqxmd.com/read/29627769/development-and-validation-of-an-admission-prediction-tool-for-emergency-departments-in-the-netherlands
#18
Nicole Kraaijvanger, Douwe Rijpsma, Lian Roovers, Henk van Leeuwen, Karin Kaasjager, Lillian van den Brand, Laura Horstink, Michael Edwards
OBJECTIVE: Early prediction of admission has the potential to reduce length of stay in the ED. The aim of this study is to create a computerised tool to predict admission probability. METHODS: The prediction rule was derived from data on all patients who visited the ED of the Rijnstate Hospital over two random weeks. Performing a multivariate logistic regression analysis factors associated with hospitalisation were explored. Using these data, a model was developed to predict admission probability...
April 7, 2018: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/29615112/where-to-from-here-a-quality-improvement-project-investigating-burns-treatment-and-rehabilitation-practices-in-india
#19
J Jagnoor, C Lukaszyk, A Christou, T Potokar, S Chamania, R Ivers
OBJECTIVE: To describe the capacity of the Indian healthcare system in providing appropriate and effective burns treatment and rehabilitation services. RESULTS: Health professionals involved in burns treatment or rehabilitation at seven hospitals from four states in India were invited to participate in consultative meetings. Existing treatment and rehabilitation strategies, barriers and enablers to patient flow across the continuum of care and details on inpatient and outpatient rehabilitation were discussed during the meetings...
April 3, 2018: BMC Research Notes
https://www.readbyqxmd.com/read/29609612/association-between-age-and-outpatient-clinic-arrival-time-myth-or-reality
#20
Kashif Waqar Faiz, Espen Saxhaug Kristoffersen
BACKGROUND: Non-attendance and late arrivals diminish patient flow in outpatient clinics. On the other hand, patient earliness may also be undesirable. Physicians often experience that older patients are more punctual than younger patients, and often they come excessively early. The aim of this study was to determine whether an association between age and outpatient clinic arrival time could be established or not, i.e. to find out if it is a myth or a reality. METHODS: Prospective descriptive study performed at a neurological outpatient clinic...
April 2, 2018: BMC Health Services Research
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