scholarly journals EP-1856: The impact of waiting time on survival of Lung Stereotactic Ablative Body Radiotherapy patients

2017 ◽  
Vol 123 ◽  
pp. S1014
Author(s):  
Y. Tsang ◽  
P. Nariyangadu ◽  
N. Shah ◽  
P. Ostler ◽  
P. Hoskin
Keyword(s):  
Waiting Time ◽  
Stereotactic Ablative Body Radiotherapy ◽  
The Impact

scholarly journals The Impact of Longer Consultation Time: A Simulation-Based Approach

2020 ◽  
Vol 11 (05) ◽  
pp. 857-864
Author(s):  
Abdulrahman M. Jabour
Keyword(s):  
Waiting Time ◽  
Quality Care ◽  
Working Hours ◽  
Discrete Events ◽  
Simulation Based ◽  
Patient Waiting Time ◽  
Free Environment ◽  
The Impact ◽  
Consultation Time ◽  
Patient Waiting

Abstract Background Maintaining a sufficient consultation length in primary health care (PHC) is a fundamental part of providing quality care that results in patient safety and satisfaction. Many facilities have limited capacity and increasing consultation time could result in a longer waiting time for patients and longer working hours for physicians. The use of simulation can be practical for quantifying the impact of workflow scenarios and guide the decision-making. Objective To examine the impact of increasing consultation time on patient waiting time and physician working hours. Methods Using discrete events simulation, we modeled the existing workflow and tested five different scenarios with a longer consultation time. In each scenario, we examined the impact of consultation time on patient waiting time, physician hours, and rate of staff utilization. Results At baseline scenarios (5-minute consultation time), the average waiting time was 9.87 minutes and gradually increased to 89.93 minutes in scenario five (10 minutes consultation time). However, the impact of increasing consultation time on patients waiting time did not impact all patients evenly where patients who arrive later tend to wait longer. Scenarios with a longer consultation time were more sensitive to the patients' order of arrival than those with a shorter consultation time. Conclusion By using simulation, we assessed the impact of increasing the consultation time in a risk-free environment. The increase in patients waiting time was somewhat gradual, and patients who arrive later in the day are more likely to wait longer than those who arrive earlier in the day. Increasing consultation time was more sensitive to the patients' order of arrival than those with a shorter consultation time.

scholarly journals Investigation of the Impact of Micro-Structuring on the Bonding Performance of Beechwood (Fagus Sylvatica L.)

Forests ◽  
2022 ◽  
Vol 13 (1) ◽  
pp. 113
Author(s):  
Destin Bamokina Moanda ◽  
Martin Lehmann ◽  
Peter Niemz
Keyword(s):  
Bond Strength ◽  
Waiting Time ◽  
Type I ◽  
Bond Quality ◽  
Structured Surfaces ◽  
Structured Surface ◽  
Bonding Performance ◽  
Delamination Resistance ◽  
Micro Structuring ◽  
The Impact

Although glueing softwood is well mastered by the industry, predicting and controlling bond quality for hardwood is still challenging after years of research. Parameters such as the adhesive type, resin–hardener ratio, and the penetration behaviour of the wood are determinants for the bond quality. The aim of this work was to assess to what extent the glueing behaviour of beechwood can be improved by using structural planing. The different surfacing methods were characterised by their roughness. The bond strength of the micro-structured surfaces was determined according to EN 302-1, and the delamination resistance was tested as indicated by EN 302-2 for type I adhesives. Micro-structured surfaces were compared with different surfaces (generated by surfacing methods such as dull/sharp planing and sanding). In dry test conditions, all surfacing methods gave satisfying results. In the wet stage, the bond strength on the finer micro-structured surface slightly outperformed the coarse structure surface. For the delamination resistance, a clear improvement could be observed for melamine-formaldehyde-bonded specimens since, when using the recommended amount of adhesive, micro-structured surfaces fulfilled the requirements. Nevertheless, structural planing cannot lead to a reduction in the applied grammage since no sample with a smaller amount fulfilled EN 302-2 requirements even by observing the recommended closed assembly waiting time. Adhesion area enlargement of the micro-structuring is minor. The good delamination performance without waiting time (CAT) is not caused by surface enlargement, since finer micro-structured surface with negligible area increase and delivered even better delamination resistance. Subsurface analysis should be carried out to thoroughly investigate this phenomenon.

scholarly journals The Impact of COVID-19 on Gastric Cancer Surgery: A Single-Center Retrospective Study

2020 ◽  
Author(s):  
Yu-xuan Li ◽  
Chang-zheng He ◽  
Yi-chen Liu ◽  
Peng-yue Zhao ◽  
Xiao-lei Xu ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Waiting Time ◽  
World Health ◽  
Abdominal Ct ◽  
Surgical Strategies ◽  
Patients With Cancer ◽  
Global Pandemic ◽  
Health Organization ◽  
Gastric Cancer Patients ◽  
The Impact

Abstract Background: The coronavirus disease 2019 (COVID-19) has been declared a global pandemic by the World Health Organization. Patients with cancer are more likely to incur poor clinical outcomes. Due to the prevailing pandemic, we propose some surgical strategies for gastric cancer patients. Methods: The ‘COVID-19’ period was defined as occurring between 2020-01-20 and 2020-03-20. The enrolled patients were divided into two groups, pre-COVID-19 group (PCG) and COVID-19 group (CG). A total of 109 patients with gastric cancer were enrolled in this study. Results: The waiting time before admission increased by 4 days in the CG (PCG: 4.5 [IQR: 2, 7.8] vs. CG: 8.0 [IQR: 2,20]; p=0.006). More patients had performed chest CT scans besides abdominal CT before admission during the COVID-19 period (PCG: 22 [32%] vs. CG: 30 [73%], p=0.001). After admission during the COVID period, the waiting time before surgery was longer (PCG: 3[IQR: 2,5] vs. CG: 7[IQR: 5,9]; p<0.001), more laparoscopic surgeries were performed (PCG: 51[75%] vs. CG: 38[92%], p=0.021), and hospital stay period after surgery was longer (7[IQR: 6,8] vs.9[IQR:7,11]; p<0.001). In addition, the total cost of hospitalization increased during this period, (PCG: 9.22[IQR:7.82,10.97] vs. CG: 10.42[IQR:8.99,12.57]; p=0.006). Conclusion: This study provides an opportunity for our surgical colleagues to reflect on their own services and any contingency plans they may have to tackle the COVID-19 crisis.

Geographic Disparity in the United States Heart Allocation System

2019 ◽  
pp. 65-87
Author(s):  
Fatemeh Karami ◽  
Mehdi Nayebpour ◽  
Monica Gentili ◽  
Naoru Koizumi ◽  
Andrew Rivard
Keyword(s):  
United States ◽  
Mortality Rate ◽  
Waiting Time ◽  
Average Distance ◽  
The United States ◽  
Allocation Model ◽  
Geographic Disparity ◽  
Transplant Candidates ◽  
Geographic Equity ◽  
The Impact

Organ allocation for transplantation across the United States is administered by the United Network for Organ Sharing (UNOS). UNOS recently approved a major policy change of the system used to allocate hearts for adult transplant candidates. The main objective of this study is to investigate the impact of the new policy on geographic disparity measured by four performance indicators (waiting time before a transplant, transplant rate, pre-transplant mortality rate, and average distance traveled by donated hearts). The current policy and the new policy were evaluated using the thoracic simulation allocation model. The results show that the new policy improves the median waiting time, transplant rate, and pre-transplant mortality rate. The overall predicted improvement in geographic equity is modest except in terms of waiting time. The findings highlight the need for a targeted approach for donor heart allocation to achieve equal access to heart transplantation in the US.

scholarly journals The Role of Adenosine in Pulmonary Vein Isolation: A Critical Review

2016 ◽  
Vol 2016 ◽  
pp. 1-13 ◽  
Author(s):  
Paolo D. Dallaglio ◽  
Timothy R. Betts ◽  
Matthew Ginks ◽  
Yaver Bashir ◽  
Ignasi Anguera ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
At Risk ◽  
Pulmonary Vein ◽  
Pulmonary Vein Isolation ◽  
Waiting Time ◽  
Critical Review ◽  
Recurrence Rates ◽  
The Impact ◽  
Af Recurrence

The cornerstone of atrial fibrillation (AF) ablation is pulmonary vein isolation (PVI), which can be achieved in more than 95% of patients at the end of the procedure. However, AF recurrence rates remain high and are related to recovery of PV conduction. Adenosine testing is used to unmask dormant pulmonary vein conduction (DC). The aim of this study is to review the available literature addressing the role of adenosine testing and determine the impact of ablation at sites of PV reconnection on freedom from AF. Adenosine infusion, by restoring the excitability threshold, unmasks reversible injury that could lead to recovery of PV conduction. The studies included in this review suggest that adenosine is useful to unmask nontransmural lesions at risk of reconnection and that further ablation at sites of DC is associated with improvement in freedom from AF. Nevertheless it has been demonstrated that adenosine is not able to predict all veins at risk of later reconnection, which means that veins without DC are not necessarily at low risk. The role of the waiting period in the setting of adenosine testing has also been analyzed, suggesting that in the acute phase adenosine use should be accompanied by enough waiting time.

scholarly journals Clinical characteristics and outcomes of hospitalised patients with COVID-19 treated in Hubei (epicentre) and outside Hubei (non-epicentre): a nationwide analysis of China

2020 ◽  
Vol 55 (6) ◽  
pp. 2000562 ◽  
Author(s):  
Wen-hua Liang ◽  
Wei-jie Guan ◽  
Cai-chen Li ◽  
Yi-min Li ◽  
Heng-rui Liang ◽  
...  
Keyword(s):  
Critical Illness ◽  
Waiting Time ◽  
Symptom Onset ◽  
Clinical Characteristics ◽  
Hubei Province ◽  
Hospitalised Patients ◽  
Severe Event ◽  
Prolonged Duration ◽  
Key Factor ◽  
The Impact

BackgroundDuring the outbreak of coronavirus disease 2019 (COVID-19), consistent and considerable differences in disease severity and mortality rate of patients treated in Hubei province compared to those in other parts of China have been observed. We sought to compare the clinical characteristics and outcomes of patients being treated inside and outside Hubei province, and explore the factors underlying these differences.MethodsCollaborating with the National Health Commission, we established a retrospective cohort to study hospitalised COVID-19 cases in China. Clinical characteristics, the rate of severe events and deaths, and the time to critical illness (invasive ventilation or intensive care unit admission or death) were compared between patients within and outside Hubei. The impact of Wuhan-related exposure (a presumed key factor that drove the severe situation in Hubei, as Wuhan is the epicentre as well the administrative centre of Hubei province) and the duration between symptom onset and admission on prognosis were also determined.ResultsAt the data cut-off (31 January 2020), 1590 cases from 575 hospitals in 31 provincial administrative regions were collected (core cohort). The overall rate of severe cases and mortality was 16.0% and 3.2%, respectively. Patients in Hubei (predominantly with Wuhan-related exposure, 597 (92.3%) out of 647) were older (mean age 49.7 versus 44.9 years), had more cases with comorbidity (32.9% versus 19.7%), higher symptomatic burden, abnormal radiologic manifestations and, especially, a longer waiting time between symptom onset and admission (5.7 versus 4.5 days) compared with patients outside Hubei. Patients in Hubei (severe event rate 23.0% versus 11.1%, death rate 7.3% versus 0.3%, HR (95% CI) for critical illness 1.59 (1.05–2.41)) have a poorer prognosis compared with patients outside Hubei after adjusting for age and comorbidity. However, among patients outside Hubei, the duration from symptom onset to hospitalisation (mean 4.4 versus 4.7 days) and prognosis (HR (95%) 0.84 (0.40–1.80)) were similar between patients with or without Wuhan-related exposure. In the overall population, the waiting time, but neither treated in Hubei nor Wuhan-related exposure, remained an independent prognostic factor (HR (95%) 1.05 (1.01–1.08)).ConclusionThere were more severe cases and poorer outcomes for COVID-19 patients treated in Hubei, which might be attributed to the prolonged duration of symptom onset to hospitalisation in the epicentre. Future studies to determine the reason for delaying hospitalisation are warranted.

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