scholarly journals EP.FRI.1023 Clinical Portal: a clinician-led IT solution to the ‘surgical list’

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Cait Bleakley ◽  
Chloe Wright ◽  
Rola Salem ◽  
Kirk Bowling
Keyword(s):  
Patient Information ◽  
Single Point ◽  
Direct Consequence ◽  
Direct Access ◽  
Accurate Information ◽  
Junior Doctors ◽  
Post Intervention ◽  
It Systems ◽  
The Creation ◽  
The Impact

Abstract Aim Burnout amongst junior doctors is an emotive topic, with time pressures during busy on-call shifts negatively impacting efficiency and morale. Historically, within busy surgical firms the most junior team members commonly worked beyond scheduled hours. It has been highlighted within our trust that our IT systems significantly contributed to this. Thus leading to the creation of a clinician-led IT solution, enabling direct access to accurate information at a single point.  This study aims to measure the impact of the systems introduction on efficiency and shift experience of our junior doctors.  Methods 'Clinical Portal’ was introduced in August 2019. This IT system enables all patient information to be collated in one place, with the added benefit of simplifying the creation of patient lists. Number and duration of Exception Reports (ER) by on-call surgical juniors were measured for two months pre and post intervention. A qualitative survey was also distributed to this cohort to measure satisfaction and experience during on-call shifts within this period.  Results Following introduction of 'Clinical Portal', the total length of time included in ERs reduced. Surgical juniors expressed an improvement in their on-call experience, most notably dedicating less time to collating patient information and ward list formation. The overall experience improved despite time required to become proficient at using the new system.  Conclusions Streamlining of IT systems used during on-call shifts demonstrates improved efficiency amongst juniors reflected in a reduction of ERs. A direct consequence of these implemented changes is significant improvement in morale amongst our juniors. 

scholarly journals Improving knowledge and confidence in the acute management of eating disorders and resulting complications

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S186-S186
Author(s):  
Sarah Fynes-Clinton ◽  
Clare Price ◽  
Louisa Beckford ◽  
Maisha Shahjahan ◽  
Brendan McKeown
Keyword(s):  
Eating Disorders ◽  
Clinical Information ◽  
Easy Access ◽  
Average Score ◽  
Junior Doctors ◽  
Refeeding Syndrome ◽  
Improvement Project ◽  
Positive Effects ◽  
The Creation ◽  
The Impact

AimsThis project aimed to improve the knowledge and confidence of doctors at all levels when managing patients with eating disorders while on call.BackgroundA recent survey found just 1% of doctors have the opportunity for clinical experience on eating disorders. Anecdotally, a number of junior doctors within our trust had mentioned that they felt unsure when asked to manage patients with eating disorders during their out of hours shifts.MethodThis project aimed to ascertain levels of confidence with managing patients with eating disorders, and to collect suggestions to improve this. This was achieved using a survey sent out to 97 doctors working in a Mental Health Trust.We then utilised two of the suggestions to improve the identified areas of concern. The first method involved direct lectures. This was followed up with the creation of a poster highlighting the pertinent information which was displayed in key clinical areas. The second avenue was the creation of an information booklet covering key clinical information that is available to all on call doctors.ResultThe response rate for the survey was 37.11%. The survey found that doctors lacked confidence in the management of common conditions that arise in patients admitted with eating disorders. Refeeding syndrome was identified as the greatest area of concern by responding doctors.To assess the impact of the lectures, MCQs were given out before and after the presentation. The results were compared, and showed a clear improvement in overall knowledge, with results going from an average score of 56.6% to 80%.ConclusionBy using multiple methods to improve doctors confidence, (lectures, written information and visual posters), this quality improvement project achieved its aims in improving doctors knowledge, and through having easy access to important information, will have long term positive effects on patient care.

A multifaceted intervention package to improve the diagnosis and management of delirium

2014 ◽  
Vol 27 (2) ◽  
pp. 337-342 ◽  
Author(s):  
J. Fleet ◽  
S. Chen ◽  
F.C. Martin ◽  
T. Ernst
Keyword(s):  
Confusion Assessment Method ◽  
Assessment Method ◽  
Multifaceted Intervention ◽  
Junior Doctors ◽  
Intervention Package ◽  
Post Intervention ◽  
Convenience Sample ◽  
Pharmacological Management ◽  
Hospital Patients ◽  
The Impact

ABSTRACTBackground:Delirium is a major cause of morbidity and mortality amongst hospital patients. Previous studies have shown that it is often poorly recognized and managed. We wanted to assess the impact of a multifaceted intervention on delirium management.Methods:A pre/post-intervention design was used. The local hospital delirium guideline was adapted into A7 sized cards and A3/A2 posters. Cards were distributed to junior doctors and teaching sessions were held. Computer screen savers were displayed and delirium promotion days held. The pre/post-intervention data were used to audit the following: delirium knowledge through questionnaires, documented use of the confusion assessment method (CAM) and identification and management of eight common precipitating factors. Re-audit was four months post baseline with interventions within this period. χ2 tests were used for statistical analysis.Results:A convenience sample of randomly selected doctors in postgraduate training posts completed 100 questionnaires and 25 clinical notes were selected via retrospective identification of delirium. Results from questionnaires demonstrated significant improvements in: recognizing CAM as the diagnostic tool for delirium (24% vs. 71%, p < 0.01); identifying haloperidol as first line in pharmacological management (55% vs. 98%, p <0.01) and its correct dose (40% vs. 67%, p <0.01). In clinical practice, there was significant improvement in documentation of CAM for inpatient delirium assessments (0% vs. 77%, p <0.01). Trainees found the delirium card “very helpful” (82%) and carried it with them at all times (70%).Conclusion:This multifaceted intervention increased CAM use in delirium recognition and improved the knowledge of pharmacological management. The delirium card was highly popular.

scholarly journals Identifying the impact of information logistics on contemporary conceptions of logistics

2018 ◽  
Vol 78 ◽  
pp. 167-177 ◽  
Author(s):  
Dariusz Weiland
Keyword(s):  
21St Century ◽  
Modern Technology ◽  
Current Situation ◽  
It Systems ◽  
Information Logistics ◽  
The Creation ◽  
The Impact

The contemporary economy is characterized by high reliance on modern technology, IT systems, and analyses of large amounts of information and data. This reliance promotes creation of new, innovative logistics concepts. Many practitioners and scientists have described the current situation as a logistics revolution, logistics 4.0 or logistics of the 21st century. This article attempts to systematize this terminology and present the foundation of modern strategies within logistics. What influenced the creation and functioning of the contemporary logistics strategies was the logistics of information and rationalization processes occurring within it. The aim of the article is to identify the impact of information logistics on the development and functioning of selected, contemporary logistics concepts.

scholarly journals Sharing knowledge is the key to success in a patient-physician relationship: how to produce a patient information leaflet on COPD

2016 ◽  
Vol 69 (2) ◽  
Author(s):  
D. Scala ◽  
S. Cozzolino ◽  
G. D’Amato ◽  
G. Cocco ◽  
A. Sena ◽  
...  
Keyword(s):  
Patient Information ◽  
Positive Impact ◽  
Patient Information Leaflet ◽  
Rank Test ◽  
Chronic Obstructive ◽  
Information Leaflet ◽  
Multiple Choice Questions ◽  
Post Intervention ◽  
Obstructive Pulmonary Disease ◽  
The Impact

Background. Chronic Obstructive Pulmonary Disease (COPD) is a leading cause of morbidity and mortality worldwide, and its prevalence is rising. In Italy, respiratory diseases are the third most common cause of death. The aim of the study is to produce a patient information leaflet (PIL) designed to educate patients about COPD in accordance with the best recommendations based on evidence and guidelines for the production of good quality written information, and to evaluate the impact of this intervention on the patients’ knowledge of COPD. Methods. The study was conducted in the Department of Chest Diseases of the Cardarelli Hospital, Naples, Italy. A total of 166 patients admitted with a diagnosis of COPD participated in the study. Patients were asked to answer 10 multiple-choice questions compiled to assess their knowledge of the disease and then to read the leaflet. Two days later they were asked to complete the questionnaire again to assess their post-intervention knowledge. Analysis of the data was performed using SPSS version 15.0. Results. After reading the leaflet, a statistically significant increase in the proportion of correct responses was noted (p&lt;0.001 by Wilcoxon signed rank test). Patients had retained the knowledge gained at the one year followup (p&lt;0.05 by Cochran’s Q test). Conclusions. An educational intervention directed at adults with COPD had a positive impact on the patients’ knowledge of COPD and this effect is long lasting.

Cost Effective Virtual Intensive Care Unit Expanding Capabilities in Critical Access Hospitals

2021 ◽  
pp. 000313482110626
Author(s):  
Lauren M. Dudas ◽  
James M. Bardes ◽  
Afton K. Wagner ◽  
Teresa White ◽  
Alison M. Wilson
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Financial Burden ◽  
Care Center ◽  
Single Point ◽  
Tertiary Care ◽  
Cost Effective ◽  
Post Intervention ◽  
Critical Access Hospital ◽  
The Impact

Background Tele-consults provide access to specialized care for a specific question and single point in time. eICU models utilize remote monitoring and ordering but have significant financial burden. We developed a virtual intensive care unit (VICU) for daily input of an intensivist working with local physicians. The purpose was to expand the acute care ability of the critical access hospital (CAH). The study evaluates the impact on the CAH and system. Methods The CAH developed an ICU team, led by a hospitalist, who staffed the intensive care unit (ICU). The CAH ICU team rounds daily via a secure video link to provide care in consultation with intensivists based at a university, tertiary care center (TC). A retrospective analysis was conducted 6 months before and after implementation (4/2018-3/2019). Fisher’s exact test was used to compare pre- and post-intervention with significance at P < .04. Results After VICU implementation, there were 265 initial daily and 35 follow-up consults. Monthly transfers to a higher level of care decreased from 63 to 57 ( P = .03). Transfers to TC increased from 49.6 to 62.0% ( P = .001). Critical access hospital average monthly census and average monthly inpatient days increased (69 to 130 ( P < .0001) and 158 to 319 ( P < .0001), respectively). Critical access hospital physicians report increased comfort to admit ICU and non-ICU patients due to the program. The total startup cost was $5180. CAH hired 11 providers. There were no unanticipated deaths. Discussion VICU implementation resulted in new CAH jobs. The CAH experienced increased inpatient census and revenues (ICU and non-ICU) while decreasing patients transferred out of the system.

Audiology Service Models in a Family Physician Practice Setting

2010 ◽  
Vol 6 (1) ◽  
pp. 24-32 ◽  
Author(s):  
Sridhar Krishnamurti
Keyword(s):  
Pediatric Patients ◽  
Practice Patterns ◽  
Healthcare Delivery ◽  
Direct Consequence ◽  
Direct Access ◽  
Practice Setting ◽  
Pediatric Populations ◽  
Family Practice Physicians ◽  
Primary Focus ◽  
Balance Problems

This article illustrates the potential of placing audiology services in a family physician’s practice setting to increase referrals of geriatric and pediatric patients to audiologists. The primary focus of family practice physicians is the diagnosis/intervention of critical systemic disorders (e.g., cardiovascular disease, diabetes, cancer). Hence concurrent hearing/balance disorders are likely to be overshadowed in such patients. If audiologists get referrals from these physicians and have direct access to diagnose and manage concurrent hearing/balance problems in these patients, successful audiology practice patterns will emerge, and there will be increased visibility and profitability of audiological services. As a direct consequence, audiological services will move into the mainstream of healthcare delivery, and the profession of audiology will move further towards its goals of early detection and intervention for hearing and balance problems in geriatric and pediatric populations.

Trading faces: Complete AI face doubles avoid the uncanny valley

2020 ◽  
Author(s):  
Christopher Welker ◽  
David France ◽  
Alice Henty ◽  
Thalia Wheatley
Keyword(s):  
Artificial Intelligence ◽  
Sexual Orientation ◽  
Uncanny Valley ◽  
Torture Survivors ◽  
The Uncanny ◽  
The Creation ◽  
Full Face ◽  
The Impact

Advances in artificial intelligence (AI) enable the creation of videos in which a person appears to say or do things they did not. The impact of these so-called “deepfakes” hinges on their perceived realness. Here we tested different versions of deepfake faces for Welcome to Chechnya, a documentary that used face swaps to protect the privacy of Chechen torture survivors who were persecuted because of their sexual orientation. AI face swaps that replace an entire face with another were perceived as more human-like and less unsettling compared to partial face swaps that left the survivors’ original eyes unaltered. The full-face swap was deemed the least unsettling even in comparison to the original (unaltered) face. When rendered in full, AI face swaps can appear human and avoid aversive responses in the viewer associated with the uncanny valley.

Automated system for creating training programs for mass professional users

2020 ◽  
pp. 21-27
Author(s):  
V.K. Grigoriev ◽  
A.A. Biryukova ◽  
A. Yu. Volk ◽  
A.S. Ilyushechkin
Keyword(s):  
Experimental Verification ◽  
Training Programs ◽  
Automated System ◽  
Software Product ◽  
Learning Programs ◽  
E Learning ◽  
The Creation ◽  
The Impact

The article discusses the automation of the creation and use of e-learning programs. The impact of automating the learning of a large number of users on the effectiveness of the introduction of a new software product is analyzed. The methods and algorithms that increase the efficiency of creating electronic training programs on example of the author’s automated system “Tutor Builder” are described. The results of experimental verification of the automated system are provided.

scholarly journals Metagenomic Analysis of the Fecal Archaeome in Suckling Piglets Following Perinatal Tulathromycin Metaphylaxis

Animals ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. 1825
Author(s):  
Mohamed Zeineldin ◽  
Ameer Megahed ◽  
Benjamin Blair ◽  
Brian Aldridge ◽  
James Lowe
Keyword(s):  
Sequencing Analysis ◽  
Metagenomic Sequencing ◽  
Post Intervention ◽  
Gastrointestinal Microbiome ◽  
Health And Wellbeing ◽  
Suckling Piglets ◽  
And Function ◽  
Changes Over Time ◽  
And Control ◽  
The Impact

The gastrointestinal microbiome plays an important role in swine health and wellbeing, but the gut archaeome structure and function in swine remain largely unexplored. To date, no metagenomics-based analysis has been done to assess the impact of an early life antimicrobials intervention on the gut archaeome. The aim of this study was to investigate the effects of perinatal tulathromycin (TUL) administration on the fecal archaeome composition and diversity in suckling piglets using metagenomic sequencing analysis. Sixteen litters were administered one of two treatments (TUL; 2.5 mg/kg IM and control (CONT); saline 1cc IM) soon after birth. Deep fecal swabs were collected from all piglets on days 0 (prior to treatment), 5, and 20 post intervention. Each piglet’s fecal archaeome was composed of rich and diverse communities that showed significant changes over time during the suckling period. At the phylum level, 98.24% of the fecal archaeome across all samples belonged to Euryarchaeota. At the genus level, the predominant archaeal genera across all samples were Methanobrevibacter (43.31%), Methanosarcina (10.84%), Methanococcus (6.51%), and Methanocorpusculum (6.01%). The composition and diversity of the fecal archaeome between the TUL and CONT groups at the same time points were statistically insignificant. Our findings indicate that perinatal TUL metaphylaxis seems to have a minimal effect on the gut archaeome composition and diversity in sucking piglets. This study improves our current understanding of the fecal archaeome structure in sucking piglets and provides a rationale for future studies to decipher its role in and impact on host robustness during this critical phase of production.

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