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https://www.readbyqxmd.com/read/29137906/can-different-physicians-providing-urgent-and-non-urgent-treatment-improve-patient-flow-in-emergency-department
#1
Flora Fei-Fei Yau, Tsung-Cheng Tsai, Yan-Ren Lin, Kuan-Han Wu, Yuan-Jhen Syue, Chao-Jui Li
BACKGROUND: Emergency Department (ED) overcrowding is a worldwide problem, and it might be caused by prolonged patient stay in the ED. This study tried to analyze if different practice models influence patient flow in the ED. MATERIALS AND METHODS: A retrospective, 1-year cohort study was conducted across two EDs in the largest healthcare system in Taiwan. A total of 37,580 adult non-trauma patients were involved in the study. The clinical practice between two ED practice models was compared...
November 6, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29124916/how-collaboration-is-improving-acute-hospital-admission-for-people-with-dementia
#2
Nicola Wood, Yvonne Cairns, Barbara Sharp
In November 2015 it became apparent that a person with dementia's journey through the acute hospital was not always as streamlined as it should have been. There was evidence of late and multiple inter-ward transfers for this patient group that could potentially have a detrimental effect on individuals' and carers' well-being. The aim of this project was to examine current processes around patient flow and decision-making, explore any themes arising and identify opportunities for improving transitions of care...
October 31, 2017: Nursing Older People
https://www.readbyqxmd.com/read/29121883/the-association-of-duration-of-boarding-in-the-emergency-room-and-the-outcome-of-patients-admitted-to-the-intensive-care-unit
#3
Saad Al-Qahtani, Abdullah Alsultan, Samir Haddad, Abdulmohsen Alsaawi, Moeed Alshehri, Sami Alsolamy, Afef Felebaman, Hani M Tamim, Nawfal Aljerian, Abdulaziz Al-Dawood, Yaseen Arabi
BACKGROUND: The demand for critical care beds is increasing out of proportion to bed availability. As a result, some critically ill patients are kept in the Emergency Department (ED boarding) awaiting bed availability. The aim of our study is to examine the impact of boarding in the ED on the outcome of patients admitted to the Intensive Care Unit(ICU). METHODS: This was a retrospective analysis of ICU data collected prospectively at King Abdulaziz Medical City, Riyadh from ED between January 2010 and December 2012 and all patients admitted during this time were evaluated for their duration of boarding...
November 9, 2017: BMC Emergency Medicine
https://www.readbyqxmd.com/read/29118276/factors-associated-with-the-economic-sustainability-of-the-registered-dental-hygienist-in-alternative-practice
#4
Sara L Coppola, Danielle Furgeson, Margherita Fontana, Janet S Kinney, Anne E Gwozdek
Purpose: The purpose of this study was to investigate key factors associated with the economic sustainability of the Registered Dental Hygienist in Alternative Practice (RDHAP).Methods: An invitation to participate in a 38-question electronic survey was sent via postal mail to 440 RDHAP licentiate addressees obtained through the Dental Hygiene Committee of California (DHCC). Legal restrictions did not allow for obtaining the RDHAP licentiate email addresses from the DHCC. The survey was disseminated via email to the 254 RDHAPs who were members of the California Dental Hygienists' Association...
October 2017: Journal of Dental Hygiene: JDH
https://www.readbyqxmd.com/read/29117454/factors-affecting-quality-of-nurse-shift-handover-in-the-emergency-department
#5
Heather Thomson, Ann Tourangeau, Lianne Jeffs, Martine Puts
AIM: The aim of this study was to explore and test factors hypothesized to influence quality of Emergency Department nurse-to-nurse shift handover communication. BACKGROUND: Nurse-to-nurse shift handover communication includes the transfer of information and responsibility for patients at shift change. The unique environment of the Emergency Department, where there is a high degree of patient unpredictability, increased patient volumes and rapid patient turnover, can create challenges for high quality handover communication...
November 8, 2017: Journal of Advanced Nursing
https://www.readbyqxmd.com/read/29115772/graphic-facilitation-as-a-novel-approach-to-practice-development
#6
Angela Leonard, Candice Bonaconsa, Lydia Ssenyonga, Minette Coetzee
The active participation of staff from the outset of any health service or practice improvement process ensures they are more likely to become engaged in the implementation phases that follow initial service analyses. Graphic facilitation is a way of getting participants to develop an understanding of complex systems and articulate solutions from within them. This article describes how a graphic facilitation process enabled the members of a multidisciplinary team at a specialist paediatric neurosurgery hospital in Uganda to understand how their system worked...
October 10, 2017: Nursing Children and Young People
https://www.readbyqxmd.com/read/29109578/provincial-comparison-of-pharmacist-prescribing-in-canada-using-alberta-s-model-as-the-reference-point
#7
Surya Bhatia, Scot H Simpson, Tammy Bungard
Background: In the past decade, pharmacist practice has evolved tremendously in Canada, but the scope of practice varies substantially from one province to another. Objective: To describe pharmacists' scopes of practice relevant to prescribing within various jurisdictions of Canada, using the prescribing model in Alberta (authors' province) as the reference point. Methods: This cross-sectional survey consisted of clinical scenarios for emergency prescribing, adapting or renewing a prescription, and initial-access prescribing for a chronic disease...
September 2017: Canadian Journal of Hospital Pharmacy
https://www.readbyqxmd.com/read/29105339/prognostic-value-of-cd133-cd54-cd44-circulating-tumor-cells-in-colorectal-cancer-with-liver-metastasis
#8
Chao Fang, Chuanwen Fan, Cun Wang, Qiaorong Huang, Wentong Meng, Yongyang Yu, Lie Yang, Jiankun Hu, Yuan Li, Xianming Mo, Zongguang Zhou
In the previous study, we had showed the expression of CD133(+) CD54(+) CD44(+) cellular subpopulation of circulating tumor cells (CTCs) was significantly associated with liver metastasis of colorectal cancer (CRC). This study aimed to explore whether this subpopulation of CTCs have a prognostic value in CRC patients. Flow cytometry was used to detect the expression of cellular subpopulations of CTCs with CD133, CD54, and CD44 in 152 CRC patients, between December 2013 and October 2014. The impact of clinicopathological factors and the expression of cellular subpopulations of CTCs on overall survival were then analyzed...
November 3, 2017: Cancer Medicine
https://www.readbyqxmd.com/read/29088994/a-generic-simulation-model-of-the-relative-cost-effectiveness-of-icu-versus-step-down-imcu-expansion
#9
Amin Mahmoudian-Dehkordi, Somayeh Sadat
BACKGROUND: Many jurisdictions are facing increased demand for intensive care. There are two long-term investment options: intensive care unit (ICU) versus step-down or intermediate care unit (IMCU) capacity expansion. Relative cost-effectiveness of the two investment strategies with regard to patient lives saved has not been studied to date. METHODS: We expand a generic system dynamics simulation model of emergency patient flow in a typical hospital, populated with empirical evidence found in the medical and hospital administration literature, to estimate the long-term effects of expanding ICU versus IMCU beds on patient lives saved under a common assumption of 2...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/29079248/machine-learning-for-predicting-patient-wait-times-and-appointment-delays
#10
Catherine Curtis, Chang Liu, Thomas J Bollerman, Oleg S Pianykh
Being able to accurately predict waiting times and scheduled appointment delays can increase patient satisfaction and enable staff members to more accurately assess and respond to patient flow. In this work, the authors studied the applicability of machine learning models to predict waiting times at a walk-in radiology facility (radiography) and delay times at scheduled radiology facilities (CT, MRI, and ultrasound). In the proposed models, a variety of predictors derived from data available in the radiology information system were used to predict waiting or delay times...
October 24, 2017: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/29072887/axiomatic-design-of-a-framework-for-the-comprehensive-optimization-of-patient-flows-in-hospitals
#11
Gabriele Arcidiacono, Dominik T. Matt, Erwin Rauch
Lean Management and Six Sigma are nowadays applied not only to the manufacturing industry but also to service industry and public administration. The manifold variables affecting the Health Care system minimize the effect of a narrow Lean intervention. Therefore, this paper aims to discuss a comprehensive, system-based approach to achieve a factual holistic optimization of patient flows. This paper debates the efficacy of Lean principles applied to the optimization of patient flows and related activities, structures, and resources, developing a theoretical framework based on the principles of the Axiomatic Design...
2017: Journal of Healthcare Engineering
https://www.readbyqxmd.com/read/29067683/redesigning-induction-of-labour-processes
#12
Michael Beckmann, Emma Paterson, Ashleigh Smith
BACKGROUND: An 'in-hours' birth represents a desired outcome following induction of labour (IOL) in terms of safety, efficiency and satisfaction. Women booked for IOL are often not commenced at their allocated times, and these sometimes complex births happen after-hours. AIMS: To measure the effect of an 11:00 hours commencement time for IOL. MATERIALS AND METHODS: A discrete-event-simulation patient-flow model was constructed. Multiple staffing and scheduling combinations were tested, before a brief pilot and subsequent introduction of a second IOL commencement time...
October 25, 2017: Australian & New Zealand Journal of Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/29065578/axiomatic-design-of-a-framework-for-the-comprehensive-optimization-of-patient-flows-in-hospitals
#13
Gabriele Arcidiacono, Dominik T Matt, Erwin Rauch
Lean Management and Six Sigma are nowadays applied not only to the manufacturing industry but also to service industry and public administration. The manifold variables affecting the Health Care system minimize the effect of a narrow Lean intervention. Therefore, this paper aims to discuss a comprehensive, system-based approach to achieve a factual holistic optimization of patient flows. This paper debates the efficacy of Lean principles applied to the optimization of patient flows and related activities, structures, and resources, developing a theoretical framework based on the principles of the Axiomatic Design...
2017: Journal of Healthcare Engineering
https://www.readbyqxmd.com/read/29059833/two-parameter-leak-estimation-in-non-invasive-ventilation
#14
Francesco Vicario, Samiya Alkhairy, Roberto Buizza, William A Truschel
In this paper we present a method for the estimation of leaks in non-invasive ventilation. Accurate estimation of leaks is a key component of a ventilator, since it determines the ventilator performance in terms of patient-ventilator synchrony and air volume delivery. In particular, in non-invasive ventilation, the patient flow is significantly different from the flow measured at the ventilator outlet. This is mostly due to the vent orifice along the tube that is used for exhalation, but also to the non-intentional leaks that occur elsewhere in the circuit (e...
July 2017: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/29055662/organization-in-response-to-massive-afflux-of-war-victims-in-civilian-practice%C3%A2-%C3%A2-experimental-feedback-from-the-november-2015-paris-terrorist-attacks
#15
M Borel, R Rousseau, F Le Saché, D Pariente, S Castro, M Delay, P Hausfater, M Raux, F Menegaux
The arrival of a large number of war-weapon casualties at a civilian trauma center requires anticipation. A plan defining the management principles and the respective roles of the involved physicians and nurses and their interaction with each other is essential. Uni-directional patient flow associated with adequate numbers of staff physicians and nurses under the leadership of a medical director is essential to prevent the overwhelming of the trauma center. Routine and regular interaction between the pre-hospital medical flow control system and the medical director, on one hand, and between surgical teams and the medical director, on the other, are necessary to know when to apply "damage control" surgical techniques...
October 18, 2017: Journal of Visceral Surgery
https://www.readbyqxmd.com/read/28991813/using-discrete-event-simulation-to-promote-quality-improvement-and-efficiency-in-a-radiation-oncology-treatment-center
#16
Robin M Famiglietti, Emily C Norboge, Valentine Boving, James R Langabeer, Thomas A Buchholz, Osama Mikhail
BACKGROUND: To meet demand for radiation oncology services and ensure patient-centered safe care, management in an academic radiation oncology department initiated quality improvement efforts using discrete-event simulation (DES). Although the long-term goal was testing and deploying solutions, the primary aim at the outset was characterizing and validating a computer simulation model of existing operations to identify targets for improvement. METHODS: The adoption and validation of a DES model of processes and procedures affecting patient flow and satisfaction, employee experience, and efficiency were undertaken in 2012-2013...
October 2017: Quality Management in Health Care
https://www.readbyqxmd.com/read/28979569/reply-to-response-to-inpatient-illness-severity-surveys-provide-essential-data-for-planning-capacity-and-managing-patient-flow-in-the-acute-hospital-setting-j-intensive-care-soc-2016-18-175-176
#17
https://www.readbyqxmd.com/read/28979568/response-to-inpatient-illness-severity-surveys-provide-essential-data-for-planning-capacity-and-managing-patient-flow-in-the-acute-hospital-setting-j-intensive-care-soc-2016-17-196-201
#18
Oliver Redfern, Gary Smith, David Prytherch, Caroline Kovacs, Paul Meredith, Paul Schmidt, Jim Briggs
No abstract text is available yet for this article.
May 2017: J Intensive Care Soc
https://www.readbyqxmd.com/read/28970026/the-impact-of-the-improvement-in-internal-medicine-consultation-process-on-emergency-department-length-of-stay
#19
Sangheon Shin, Soo Hoon Lee, Dong Hoon Kim, Seong Chun Kim, Tae Yun Kim, Changwoo Kang, Jin Hee Jeong, Daesung Lim, Yong Joo Park, Sang Bong Lee
INTRODUCTION: Although consultations are essential for delivering safe, high-quality care to patients in emergency departments, they contribute to emergency department patient flow problems and overcrowding which is associated with several adverse outcomes, such as increases in patient mortality and poor quality care. This study aimed to investigate how time flow metrics including emergency department length of stay is influenced by changes to the internal medicine consultation policy...
September 28, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28968472/network-analysis-of-patient-flow-in-two-uk-acute-care-hospitals-identifies-key-sub-networks-for-a-e-performance
#20
Daniel M Bean, Clive Stringer, Neeraj Beeknoo, James Teo, Richard J B Dobson
The topology of the patient flow network in a hospital is complex, comprising hundreds of overlapping patient journeys, and is a determinant of operational efficiency. To understand the network architecture of patient flow, we performed a data-driven network analysis of patient flow through two acute hospital sites of King's College Hospital NHS Foundation Trust. Administration databases were queried for all intra-hospital patient transfers in an 18-month period and modelled as a dynamic weighted directed graph...
2017: PloS One
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