Ethics in the Outpatient Setting: New Challenges and Opportunities

1997 ◽  
Vol 6 (3) ◽  
pp. 293-298 ◽  
Author(s):  
Ernlé W.D. Young
Keyword(s):  
Cost Effectiveness ◽  
Patient Care ◽  
Ethics Committees ◽  
Outpatient Setting ◽  
Challenges And Opportunities ◽  
New Challenges ◽  
Per Se

It is not the outpatient setting, per se, that is presenting new challenges and opportunities to ethics consultants and ethics committees. Rather, it is the underlying reason for shifting more and more patient care from the inpatient to the outpatient setting-namely, calculations of cost-effectiveness.

scholarly journals NO direct decomposition: Progresses, challenges and opportunities

2021 ◽  
Author(s):  
Pingping Xie ◽  
Wenxue Ji ◽  
Yongdan Li ◽  
Cuijuan Zhang
Keyword(s):  
Cost Effectiveness ◽  
Direct Decomposition ◽  
Challenges And Opportunities ◽  
The Ideal

NO direct decomposition is deemed as the ideal technology to diminish NO from exhaust waste owing to its cost-effectiveness and eco-friendliness characteristics. However, its wide application is seriously impeded by...

scholarly journals 229. Hospitalists Antimicrobial Scorecard Improves Antibiotic Prescribing at a Community Teaching Hospital

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S116-S116
Author(s):  
Julia Sessa ◽  
Helen Jacoby ◽  
Bruce Blain ◽  
Lisa Avery
Keyword(s):  
Patient Care ◽  
Teaching Hospital ◽  
Antimicrobial Stewardship ◽  
Rank Order ◽  
Antibiotic Use ◽  
Outpatient Setting ◽  
Antibiotic Prescribing ◽  
Full Time ◽  
Days Of Therapy ◽  
The Impact

Abstract Background Measuring antimicrobial consumption data is a foundation of antimicrobial stewardship programs. There is data to support antimicrobial scorecard utilization to improve antibiotic use in the outpatient setting. There is a lack of data on the impact of an antimicrobial scorecard for hospitalists. Our objective was to improve antibiotic prescribing amongst the hospitalist service through the development of an antimicrobial scorecard. Methods Conducted in a 451-bed teaching hospital amongst 22 full time hospitalists. The antimicrobial scorecard for 2019 was distributed in two phases. In October 2019, baseline antibiotic prescribing data (January – September 2019) was distributed. In January 2020, a second scorecard was distributed (October – December 2019) to assess the impact of the scorecard. The scorecard distributed via e-mail to physicians included: Antibiotic days of therapy/1,000 patient care days (corrected for attending census), route of antibiotic prescribing (% intravenous (IV) vs % oral (PO)) and percentage of patients prescribed piperacillin-tazobactam (PT) for greater than 3 days. Hospitalists received their data in rank order amongst their peers. Along with the antimicrobial scorecard, recommendations from the antimicrobial stewardship team were included for hospitalists to improve their antibiotic prescribing for these initiatives. Hospitalists demographics (years of practice and gender) were collected. Descriptive statistics were utilized to analyze pre and post data. Results Sixteen (16) out of 22 (73%) hospitalists improved their antibiotic prescribing from pre- to post-scorecard (χ 2(1)=3.68, p = 0.055). The median antibiotic days of therapy/1,000 patient care days decreased from 661 pre-scorecard to 618 post-scorecard (p = 0.043). The median PT use greater than 3 days also decreased significantly, from 18% pre-scorecard to 11% post-scorecard (p = 0.0025). There was no change in % of IV antibiotic prescribing and no correlation between years of experience or gender to antibiotic prescribing. Conclusion Providing antimicrobial scorecards to our hospitalist service resulted in a significant decrease in antibiotic days of therapy/1,000 patient care days and PT prescribing beyond 3 days. Disclosures All Authors: No reported disclosures

scholarly journals Rapid implementation of Inpatient eConsult Programme addresses new challenges for patient care during COVID-19 pandemic

2021 ◽  
pp. bmjinnov-2020-000557
Author(s):  
Sharon Rikin ◽  
Eric J Epstein ◽  
Inessa Gendlina
Keyword(s):  
Palliative Care ◽  
Infectious Diseases ◽  
Patient Care ◽  
Personal Protective Equipment ◽  
Protective Equipment ◽  
Qualitative Feedback ◽  
The Usa ◽  
New Challenges ◽  
Science Framework ◽  
Context Specific

IntroductionAt the early epicentre of the COVID-19 crisis in the USA, our institution saw a surge in the demand for inpatient consultations for areas impacted by COVID-19 (eg, infectious diseases, nephrology, palliative care) and shortages in personal protective equipment (PPE). We aimed to provide timely specialist input for consult requests during the COVID-19 pandemic by implementing an Inpatient eConsult Programme.MethodsWe used the reach, effectiveness, adoption, implementation and maintenance implementation science framework and run chart analysis to evaluate the reach, adoption and maintenance of the Inpatient eConsult Programme compared with traditional in-person consults. We solicited qualitative feedback from frontline physicians and specialists for programme improvements.ResultsDuring the study period, there were 46 available in-person consult orders and 21 new eConsult orders. At the peak of utilisation, 42% of all consult requests were eConsults, and by the end of the study period, utilisation fell to 20%. Qualitative feedback revealed subspecialties best suited for eConsults (infectious diseases, nephrology, haematology, endocrinology) and influenced improvements to the ordering workflow, documentation, billing and education regarding use.DiscussionWhen offered inpatient eConsult requests as an alternative to in-person consults in the context of a surge in patients with COVID-19, frontline physicians used eConsult requests and decreased use of in-person consults. As the demand for consults decreased and PPE shortages were no longer a major concern, eConsult utilisation decreased, revealing a preference for in-person consultations when possible.ConclusionsLessons learnt can be used to develop and implement inpatient eConsults to meet context-specific challenges at other institutions.

scholarly journals Bot Datasets on Twitter: Analysis and Challenges

2021 ◽  
Vol 11 (9) ◽  
pp. 4105
Author(s):  
Luis Daniel Samper-Escalante ◽  
Octavio Loyola-González ◽  
Raúl Monroy ◽  
Miguel Angel Medina-Pérez
Keyword(s):  
Information Exchange ◽  
Modern Society ◽  
Online News ◽  
Social Networking Service ◽  
Public And Private ◽  
Challenges And Opportunities ◽  
Twitter Analysis ◽  
Radar Chart ◽  
New Challenges ◽  
Bot Detection

The reach and influence of social networks over modern society and its functioning have created new challenges and opportunities to prevent the misuse or tampering of such powerful tools of social interaction. Twitter, a social networking service that specializes in online news and information exchange involving billions of users world-wide, has been infested by bots for several years. In this paper, we analyze both public and private databases from the literature of bot detection on Twitter. We summarize their advantages, disadvantages, and differences, recommending which is more suitable to work with depending on the necessities of the researcher. From this analysis, we present five distinct behaviors in automated accounts exhibited across all the bot datasets analyzed from these databases. We measure their level of presence in each dataset using a radar chart for visual comparison. Finally, we identify four challenges that researchers of bot detection on Twitter have to face when using these databases from the literature.

Research on mixed learning mode based on MOOCs and micro class in internet background

2021 ◽  
pp. 1-8
Author(s):  
Zhang Zhehua
Keyword(s):  
Learning Process ◽  
Mixed Mode ◽  
Teaching And Learning ◽  
The Internet ◽  
Teaching Mode ◽  
Quality Of Teaching ◽  
Challenges And Opportunities ◽  
New Challenges ◽  
New Form

In the era of education information and globalization, a new mode of teaching and micro class has emerged in the background of the Internet, which brings new challenges and opportunities to the teaching of the classroom. MOOCs has been piloted and applied in many universities in the form of SPOC. As a new form of curriculum, micro course has been applied to the teaching and learning process. The integration of Moor and micro class resources helps to turn the classroom into a mixed mode. This article will focus on this hot topic to analyse the characteristics of the class, the characteristics of the micro class and the influence on the students and teachers, to improve the quality of teaching and to realize the individualized and active study of the students. The article summarizes the results of blended teaching mode at home and abroad, and explores the development and application of MOOC and micro class resources.

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