Pilot Study: Agent-Based Exploration of Complex Data in a Hospital Environment

Background: The term “financial medicine” refers to the delivery of health-related services where the generation of financial gain or “profit” takes precedence over the provision of care that is reflective of evidence-based best practice. The practicing of financial medicine includes over-servicing and overbilling, both of which have led to a sharp rise in the cost of health care and medical insurance in South Africa. For this reason, the practicing of financial medicine has been widely condemned both internationally and locally by the Health Professions Council of South Africa (HPCSA) and allied Professional bodies.Objectives: This qualitative pilot study explored and described the experiences of South African Paramedics with regard to the practicing of financial medicine in the local pre-hospital emergency care environment.Method: A sample of South African Paramedics were interviewed either face-to-face or telephonically. The interviews were audio recorded and transcripts produced. Content analysis was conducted to explore, document and describe the participants' experiences with regard to financial medicine practices in the local pre-hospital environment.Results: It emerged that all of the participants had experienced a number of financial medicine practices and associated unethical conduct. Examples included Over-servicing, Selective Patient Treatment, Fraudulent Billing Practices, Eliciting of kickbacks, incentives or benefits and Deliberate Time Wasting.Conclusion: The results of this study are concerning as the actions of service providers described by the participants constitute gross violations of the ethical and professional guidelines for health care professionals. The authors recommend additional studies be conducted to further explore these findings and to establish the reasons for, and ways of, limiting financial medicine practices in the South African emergency care environment.

Download Full-text

An agent-based approach for predictions based on multi-dimensional complex data☆

Information Sciences ◽

10.1016/j.ins.2005.07.011 ◽

2006 ◽

Vol 176 (9) ◽

pp. 1156-1174 ◽

Cited By ~ 1

Author(s):

T MA ◽

Y NAKAMORI ◽

W HUANG

Keyword(s):

Complex Data ◽

Agent Based

Download Full-text

From the hospital toilet to the ward: A pilot study on microbe dispersal to multiple hospital surfaces following hand drying using a jet air dryer versus paper towels

Infection Control and Hospital Epidemiology ◽

10.1017/ice.2021.43 ◽

2021 ◽

pp. 1-4

Author(s):

Ines B. Moura ◽

Duncan Ewin ◽

Mark H. Wilcox

Keyword(s):

Pilot Study ◽

Microbial Contamination ◽

Virus Transmission ◽

Hospital Environment ◽

Virus Contamination ◽

Air Dryer ◽

Paper Towels ◽

Hand Drying

Abstract Using a bacteriophage to represent microbial contamination, we investigated virus transmission to the hospital environment following hand drying. The use of paper towels resulted in lower rates of virus contamination on hands and clothing compared with a jet air dryer and, consequently, lower contamination of multiple hospital surfaces.

Download Full-text

009Examining the Need and Effectiveness of Reminiscence Group Therapy within an Acute Hospital Environment: A Pilot Study

Age and Ageing ◽

10.1093/ageing/afx144.54 ◽

2017 ◽

Vol 46 (Suppl_3) ◽

pp. iii13-iii59

Author(s):

Róisín McCormack ◽

Elaine O Connor ◽

Kay Murphy ◽

Mary Lunn

Keyword(s):

Pilot Study ◽

Group Therapy ◽

Acute Hospital ◽

Hospital Environment

Download Full-text

Paramedics' experiences of financial medicine practices in the pre-hospital environment. A pilot study

Health SA Gesondheid ◽

10.1016/j.hsag.2015.12.003 ◽

2016 ◽

Vol 21 ◽

pp. 103-109

Author(s):

Craig Vincent-Lambert ◽

Richard-Kyle Jackson

Keyword(s):

Pilot Study ◽

Hospital Environment

Download Full-text

Accuracy of student paramedics when measuring adult respiratory rate: a pilot study

Australasian Journal of Paramedicine ◽

10.33151/ajp.16.566 ◽

2019 ◽

Vol 16 ◽

Author(s):

Sarah Galka ◽

Jessica Berrell ◽

Rami Fezai ◽

Louis Shabella ◽

Paul Simpson ◽

...

Keyword(s):

Pilot Study ◽

Healthy Volunteers ◽

Vital Signs ◽

Saturation Temperature ◽

Predictive Marker ◽

Hospital Environment ◽

Simulated Environment ◽

The Difference ◽

Manual Blood Pressure ◽

Double Blinded

IntroductionAbnormal respiration rate (RR) is commonly undervalued in the out-of-hospital environment despite its use as a predictive marker for physiological decline. The need for paramedicine students to manually measure RR is therefore important. The aims of the study were: 1) to determine the accuracy of manually measured RR when performed by second-year paramedicine students on healthy volunteers in a simulated environment; and 2) to provide data to inform design of a larger study.MethodsThis pilot study utilised a prospective double-blinded observational design, in which neither the participants nor the healthy volunteers knew the specific aim of the study. Paramedicine students manually recorded RR along with a range of vital signs including non-invasive manual blood pressure, heart rate, oxygen saturation, temperature and 4-lead electrocardiogram on healthy volunteers. Capnography was used as the gold standard to confirm observed respiratory rates. Intra-class correlation was used to assess agreement between manual RR and capnography.ResultsThirty-six complete sets of data were recorded. There was strong agreement between paramedicine student and capnography measurements (ICC 0.77; 95% CI 0.54–0.88). Accuracy of paramedicine students to measure RR of the opposite gender showed no statistical difference when female students (F=0.05, p=0.83) or male students (F=0.04, p=0.84) measured.ConclusionThe manual RR measured by paramedicine students agreed well with capnography irrespective of the gender of the patient or paramedicine student. These data suggest the two measurements could be used interchangeably, although the difference between statistical and clinical significance should be further investigated.

Download Full-text

Use of Telepharmacy To Support Patients Using Oral Antineoplastic Agents: A Pilot Study

10.21203/rs.3.rs-472358/v1 ◽

2021 ◽

Author(s):

Cristiane Soares Cardozo Wergles ◽

Carla Valéria Vieira Guilarducci ◽

Cecília de Souza Fernandez ◽

Sabrina Calil-Elias

Keyword(s):

Pilot Study ◽

Antineoplastic Agents ◽

Antineoplastic Agent ◽

Medication Possession Ratio ◽

Self Report ◽

Military Hospital ◽

Correct Treatment ◽

Agent Based ◽

Good Communication ◽

Phone Calls

Abstract Purpose This study aims to use teleconsultation to perform pharmaceutical consultations with patients using oral antineoplastic agents, to identify their profile, and carry out activities to support the correct treatment.Methods The telepharmacy flowchart was designed considering the steps of a pharmaceutical consultation. A pilot study was carried out with 66 patients from a military hospital, who had been using oral antineoplastic agents for at least 3 months. Adherence was measured using a self-report semi-structured survey, medication possession ratio (MPR), and the proportion of days covered (PDC). The interventions were carried out through structured phone calls. Results Sixty-seven percent were male, and 33% were aged 65 to 75 years. According to the survey, 16 patients adhered to the oral antineoplastic agent. Based on MPR and PDC, 53 and 52 patients showed good persistence, respectively. When all methods were applied together, 9 patients were adherent. On average, each patient regularly uses 4.73 medicines. Most patients (83 %) reported adverse effects during treatment. Five hundred eighty-one pharmaceutical interventions were carried out, most of them corrective (29%) and related to the correct drug administration technique (29 %).Conclusions The proposed tool helped establish good communication with patients, obtain desired data, and carry out relevant interventions. However, it is necessary to carry out further consultations to verify whether the patients were able to apply the suggested recommendations in practice.

Download Full-text

Investigation of the implementation of a Communication Enhanced Environment model on an acute/slow stream rehabilitation and a rehabilitation ward: A before-and-after pilot study

Clinical Rehabilitation ◽

10.1177/02692155211032655 ◽

2021 ◽

pp. 026921552110326

Author(s):

Sarah D’Souza ◽

Erin Godecke ◽

Natalie Ciccone ◽

Deborah Hersh ◽

Elizabeth Armstrong ◽

...

Keyword(s):

Pilot Study ◽

Intervention Group ◽

Observation Time ◽

Hospital Environment ◽

Future Research ◽

Control Group ◽

Time Points ◽

Environment Model ◽

Before And After ◽

Rehabilitation Ward

Objectives: Develop and implement a Communication Enhanced Environment model and explore its effect on language activities for patients early after stroke. Method and design: Before-and-after pilot study. Setting: An acute/slow stream rehabilitation and a rehabilitation ward in a private hospital in Perth, Western Australia. Participants: Fourteen patients recruited within 21 days of stroke. Seven recruited during the before-phase (control group: patients with aphasia = 3, patients without aphasia = 4) and seven recruited in the after-phase (intervention group: patients with aphasia = 4, patients without aphasia = 3). Intervention: The intervention group exposed to a Communication Enhanced Environment model had access to equipment, resources, planned social activities and trained communication partners. Both groups received usual stroke care. Data collection: Hospital site champions monitored the availability of the intervention. Behavioural mapping completed during the first minute of each 5-minute interval over 12 hours (between 7 am and 7 pm) determined patient engagement in language activities. Results: Seventy-one percent of the Communication Enhanced Environment model was available to the intervention group who engaged in higher, but not significant (95% CI), levels of language activities (600 of 816 observation time points, 73%) than the control group (551 of 835 observation time points, 66%). Unforeseen reorganisation of the acute ward occurred during the study. Conclusions: Implementation of a Communication Enhanced Environment model was feasible in this specific setting and may potentially influence patients’ engagement in language activities. The unforeseen contextual challenges that occurred during the study period demonstrate the challenging nature of the hospital environment and will be useful in future research planning.

Download Full-text