scholarly journals Improving hospital patient flow: a systematic review

2019 ◽  
Vol 26 (6) ◽  
pp. 1541-1575
Author(s):  
Raffaella Gualandi ◽  
Cristina Masella ◽  
Daniela Tartaglini
Keyword(s):  
Performance Indicator ◽  
Patient Flow ◽  
Quality Criteria ◽  
Process Efficiency ◽  
Cochrane Library ◽  
Hospital Patient ◽  
Content Type ◽  
Wide Range ◽  
Top Management Commitment ◽  
Policy Priority

Purpose Improving hospital patient flow has become a policy priority, to effectively balance the increasing demands of an unknown and variable volume of patients with limited available hospital resources. A systematic literature review was conducted in order to identify actions, actors involved and enablers in improving hospital patient flow. The paper aims to discuss this issue. Design/methodology/approach Searches were conducted in Scopus, Web of Science, MEDLINE and The Cochrane Library for quantitative and qualitative empirical primary studies with patients (adults) receiving inpatient acute hospital care. The study protocol was based on PRISMA-P guidance. A critical appraisal of included studies was performed by using the Quality Improvement Minimum Quality Criteria Set. Findings In total, 38 key papers were identified. A wide range of actions are reported, but most studies focus on one or a few departments instead of a whole hospital. Process efficiency is most often used as a performance indicator, clinical outcomes are poorly analyzed, and patients’ expectations and experience are rarely considered. Top-management commitment and front-line staff involvement are considered key factors for the success of implementations. Patient involvement in the process improvement is rarely mentioned. Originality/value Achieving improvements in hospital patient flow requires the design and implementation of complex, multifaceted and coordinated interventions. This study may be of value to healthcare managers, helping them to act effectively in their context, and to researchers of future studies including the different variables and the patient’s perspective.

Challenges and potential improvements in hospital patient flow: the contribution of frontline, top and middle management professionals

2020 ◽  
Vol 34 (8) ◽  
pp. 829-848
Author(s):  
Raffaella Gualandi ◽  
Cristina Masella ◽  
Daniela Viglione ◽  
Daniela Tartaglini
Keyword(s):  
Healthcare Professionals ◽  
Patient Flow ◽  
A Priori ◽  
Qualitative Studies ◽  
Hospital Patient ◽  
Hospital Data ◽  
Content Type ◽  
Qualitative Interview Study ◽  
Potential Improvement ◽  
Efficient Hospital

PurposeThis study aims to describe and understand the contributions of frontline, middle and top management healthcare professionals in detecting areas of potential improvement in hospital patient flow and proposing solutions.Design/methodology/approachThis is a qualitative interview study. Semistructured interviews were conducted with 22 professionals in the orthopedic department of a 250-bed academic teaching hospital. Data were analyzed through a thematic framework analytical approach by using an a priori framework. The Consolidated Criteria for Reporting Qualitative (COREQ) checklist for qualitative studies was followed.FindingsWhen dealing with a hospital-wide process, the involvement of all professionals, including nonhealth professionals, can reveal priority areas for improvement and for services integration. The improvements identified by the professionals largely focus on covering major gaps detected in the technical and administrative quality.Research limitations/implicationsThis study focused on the professional viewpoint and the connections between services and further studies should explore the role of patient involvement. The study design could limit the generalizability of findings.Practical implicationsImproving high-quality, efficient hospital patient flow cannot be accomplished without learning the perspective of the healthcare professionals on the process of service delivery.Originality/valueFew qualitative studies explore professionals' perspectives on patient needs in hospital flow management. This study provides insights into what produces value for the patient within a complex process by analyzing the contribution of professionals from their particular role in the organization.

3D printing in tissue engineering: a state of the art review of technologies and biomaterials

2020 ◽  
Vol 26 (7) ◽  
pp. 1313-1334 ◽  
Author(s):  
Nataraj Poomathi ◽  
Sunpreet Singh ◽  
Chander Prakash ◽  
Arjun Subramanian ◽  
Rahul Sahay ◽  
...  
Keyword(s):  
Tissue Engineering ◽  
3D Printing ◽  
Regenerative Medicine ◽  
State Of The Art ◽  
Three Dimensional ◽  
Cost Effective ◽  
Cochrane Library ◽  
Content Type ◽  
Wide Range ◽  
Potential Applications

Purpose In the past decade, three-dimensional (3D) printing has gained attention in areas such as medicine, engineering, manufacturing art and most recently in education. In biomedical, the development of a wide range of biomaterials has catalysed the considerable role of 3D printing (3DP), where it functions as synthetic frameworks in the form of scaffolds, constructs or matrices. The purpose of this paper is to present the state-of-the-art literature coverage of 3DP applications in tissue engineering (such as customized scaffoldings and organs, and regenerative medicine). Design/methodology/approach This review focusses on various 3DP techniques and biomaterials for tissue engineering (TE) applications. The literature reviewed in the manuscript has been collected from various journal search engines including Google Scholar, Research Gate, Academia, PubMed, Scopus, EMBASE, Cochrane Library and Web of Science. The keywords that have been selected for the searches were 3 D printing, tissue engineering, scaffoldings, organs, regenerative medicine, biomaterials, standards, applications and future directions. Further, the sub-classifications of the keyword, wherever possible, have been used as sectioned/sub-sectioned in the manuscript. Findings 3DP techniques have many applications in biomedical and TE (B-TE), as covered in the literature. Customized structures for B-TE applications are easy and cost-effective to manufacture through 3DP, whereas on many occasions, conventional technologies generally become incompatible. For this, this new class of manufacturing must be explored to further capabilities for many potential applications. Originality/value This review paper presents a comprehensive study of the various types of 3DP technologies in the light of their possible B-TE application as well as provides a future roadmap.

Update on psychopharmacology for autism spectrum disorders

2016 ◽  
Vol 10 (1) ◽  
pp. 6-26 ◽  
Author(s):  
Marco O. Bertelli ◽  
Michele Rossi ◽  
Roberto Keller ◽  
Stefano Lassi
Keyword(s):  
Autism Spectrum Disorders ◽  
Animal Studies ◽  
Treatment Options ◽  
Autism Spectrum ◽  
Psychotropic Medications ◽  
Cochrane Library ◽  
Content Type ◽  
Wide Range ◽  
Spectrum Disorders ◽  
The Cochrane Library

Purpose – The management of individuals with autism spectrum disorders (ASDs) requires a multimodal approach of behavioural, educational and pharmacological treatments. At present, there are no available drugs to treat the core symptoms of ASDs and therefore a wide range of psychotropic medications are used in the management of problems behaviours, co-occurring psychiatric disorders and other associated features. The purpose of this paper is to map the literature on pharmacological treatment in persons with ASD in order to identify those most commonly used, choice criteria, and safety. Design/methodology/approach – A systematic mapping of the recent literature was undertaken on the basis of the following questions: What are the most frequently used psychoactive compounds in ASD? What are the criteria guiding the choice of a specific compound? How effective and safe is every psychoactive drug used in ASD? The literature search was conducted through search engines available on Medline, Medmatrix, NHS Evidence, Web of Science and the Cochrane Library. Findings – Many psychotropic medications have been studied in ASDs, but few have strong evidence to support their use. Most commonly prescribed medications, in order of frequency, are antipsychotics, antidepressants, anticonvulsants and stimulants, many of them without definitive studies guiding their usage. Recent animal studies can be useful models for understanding the common pathogenic pathways leading to ASDs, and have the potential to offer new biologically focused treatment options. Originality/value – This is a practice review paper applying recent evidence from the literature.

scholarly journals Transfer of Plasmid DNA to Clinical Coagulase-Negative Staphylococcal Pathogens by Using a Unique Bacteriophage

2015 ◽  
Vol 81 (7) ◽  
pp. 2481-2488 ◽  
Author(s):  
Volker Winstel ◽  
Petra Kühner ◽  
Bernhard Krismer ◽  
Andreas Peschel ◽  
Holger Rohde
Keyword(s):  
Plasmid Dna ◽  
Genetic Manipulation ◽  
Current Knowledge ◽  
Virulence Determinants ◽  
Coagulase Negative Staphylococci ◽  
Reliable Technique ◽  
Content Type ◽  
Research Activities ◽  
Wide Range ◽  
Genetic Barriers

ABSTRACTGenetic manipulation of emerging bacterial pathogens, such as coagulase-negative staphylococci (CoNS), is a major hurdle in clinical and basic microbiological research. Strong genetic barriers, such as restriction modification systems or clustered regularly interspaced short palindromic repeats (CRISPR), usually interfere with available techniques for DNA transformation and therefore complicate manipulation of CoNS or render it impossible. Thus, current knowledge of pathogenicity and virulence determinants of CoNS is very limited. Here, a rapid, efficient, and highly reliable technique is presented to transfer plasmid DNA essential for genetic engineering to important CoNS pathogens from a uniqueStaphylococcus aureusstrain via a specificS. aureusbacteriophage, Φ187. Even strains refractory to electroporation can be transduced by this technique once donor and recipient strains share similar Φ187 receptor properties. As a proof of principle, this technique was used to delete the alternative transcription factor sigma B (SigB) via allelic replacement in nasal and clinicalStaphylococcus epidermidisisolates at high efficiencies. The described approach will allow the genetic manipulation of a wide range of CoNS pathogens and might inspire research activities to manipulate other important pathogens in a similar fashion.

scholarly journals Use of Proteins Identified through a Functional Genomic Screen To Develop a Protein Subunit Vaccine That Provides Significant Protection against Virulent Streptococcus suis in Pigs

2017 ◽  
Vol 86 (3) ◽  
Author(s):  
Susan L. Brockmeier ◽  
Crystal L. Loving ◽  
Tracy L. Nicholson ◽  
Jinhong Wang ◽  
Sarah E. Peters ◽  
...  
Keyword(s):  
Immune Response ◽  
Vaccine Trial ◽  
Streptococcus Suis ◽  
Protein Subunit ◽  
Content Type ◽  
Degree Of Protection ◽  
Wide Range ◽  
Associated Proteins ◽  
Clinical Protection ◽  
Cellular Immune

ABSTRACT Streptococcus suis is a bacterium that is commonly carried in the respiratory tract and that is also one of the most important invasive pathogens of swine, commonly causing meningitis, arthritis, and septicemia. Due to the existence of many serotypes and a wide range of immune evasion capabilities, efficacious vaccines are not readily available. The selection of S. suis protein candidates for inclusion in a vaccine was accomplished by identifying fitness genes through a functional genomics screen and selecting conserved predicted surface-associated proteins. Five candidate proteins were selected for evaluation in a vaccine trial and administered both intranasally and intramuscularly with one of two different adjuvant formulations. Clinical protection was evaluated by subsequent intranasal challenge with virulent S. suis . While subunit vaccination with the S. suis proteins induced IgG antibodies to each individual protein and a cellular immune response to the pool of proteins and provided substantial protection from challenge with virulent S. suis , the immune response elicited and the degree of protection were dependent on the parenteral adjuvant given. Subunit vaccination induced IgG reactive against different S. suis serotypes, indicating a potential for cross protection.

scholarly journals Laboratory Test to Evaluate the Resistance of Cementitious Materials to Biodeterioration in Sewer Network Conditions

Materials ◽  
2021 ◽  
Vol 14 (3) ◽  
pp. 686
Author(s):  
Amr Aboulela ◽  
Matthieu Peyre Lavigne ◽  
Amaury Buvignier ◽  
Marlène Fourré ◽  
Maud Schiettekatte ◽  
...  
Keyword(s):  
Calcium Aluminate ◽  
Standardized Test ◽  
Performance Indicator ◽  
Cementitious Materials ◽  
Test Method ◽  
Sustainable Construction ◽  
Public Health Issue ◽  
Sulfur Source ◽  
Test Protocol ◽  
Wide Range

The biodeterioration of cementitious materials in sewer networks has become a major economic, ecological, and public health issue. Establishing a suitable standardized test is essential if sustainable construction materials are to be developed and qualified for sewerage environments. Since purely chemical tests are proven to not be representative of the actual deterioration phenomena in real sewer conditions, a biological test–named the Biogenic Acid Concrete (BAC) test–was developed at the University of Toulouse to reproduce the biological reactions involved in the process of concrete biodeterioration in sewers. The test consists in trickling a solution containing a safe reduced sulfur source onto the surface of cementitious substrates previously covered with a high diversity microbial consortium. In these conditions, a sulfur-oxidizing metabolism naturally develops in the biofilm and leads to the production of biogenic sulfuric acid on the surface of the material. The representativeness of the test in terms of deterioration mechanisms has been validated in previous studies. A wide range of cementitious materials have been exposed to the biodeterioration test during half a decade. On the basis of this large database and the expertise gained, the purpose of this paper is (i) to propose a simple and robust performance criterion for the test (standardized leached calcium as a function of sulfate produced by the biofilm), and (ii) to demonstrate the repeatability, reproducibility, and discriminability of the test method. In only a 3-month period, the test was able to highlight the differences in the performances of common cement-based materials (CEM I, CEM III, and CEM V) and special calcium aluminate cement (CAC) binders with different nature of aggregates (natural silica and synthetic calcium aluminate). The proposed performance indicator (relative standardized leached calcium) allowed the materials to be classified according to their resistance to biogenic acid attack in sewer conditions. The repeatability of the test was confirmed using three different specimens of the same material within the same experiment and the reproducibility of the results was demonstrated by standardizing the results using a reference material from 5 different test campaigns. Furthermore, developing post-testing processing and calculation methods constituted a first step toward a standardized test protocol.

The role of organizational culture in the knowledge management process

2015 ◽  
Vol 19 (3) ◽  
pp. 433-455 ◽  
Author(s):  
Christina Ling-hsing Chang ◽  
Tung-Ching Lin
Keyword(s):  
Organizational Culture ◽  
Knowledge Management ◽  
Customer Service ◽  
Survey Methodology ◽  
Cultural Dimensions ◽  
Content Type ◽  
Knowledge Resources ◽  
Positive Effects ◽  
Wide Range ◽  
The Individual

Purpose – The purpose of the study is to focus on the enhancement of knowledge management (KM) performance and the relationship between organizational culture and KM process intention of individuals because of the diversity of organizational cultures (which include results-oriented, tightly controlled, job-oriented, closed system and professional-oriented cultures). Knowledge is a primary resource in organizations. If firms are able to effectively manage their knowledge resources, then a wide range of benefits can be reaped such as improved corporate efficiency, effectiveness, innovation and customer service. Design/methodology/approach – The survey methodology, which has the ability to enhance generalization of results (Dooley, 2001), was used to collect the data utilized in the testing of the research hypotheses. Findings – Results- and job-oriented cultures have positive effects on employee intention in the KM process (creation, storage, transfer and application), whereas a tightly controlled culture has negative effects. Research limitations/implications – However, it would have been better to use a longitudinal study to collect useful long-term data to understand how the KM process would be influenced when organizational culture dimensions are changed through/by management. This is the first limitation of this study. According to Mason and Pauleen (2003), KM culture is a powerful predictor of individual knowledge-sharing behavior, which is not included in this study. Thus, this is the second limitation of this paper. Moreover, national culture could be an important issue in the KM process (Jacks et al., 2012), which is the third limitation of this paper for not comprising it. Practical implications – In researchers’ point of view, results- and job-oriented cultures have positive effects, whereas a tightly controlled culture has a negative effect on the KM process intention of the individual. These findings provide evidences that challenge the perspective of Kayworth and Leidner (2003) on this issue. As for practitioners, management has a direction to modify their organizational culture to improve the performance of KM process. Social implications – Both behavioral and value perspectives of the organizational cultural dimensions (results-oriented, tightly control, job-oriented, sociability, solidarity, need for achievement and democracy) should be examined to ascertain their effects firstly on KM culture and then on the KM process intention of the individual. It is hoped that the current study will spawn future investigations that lead to the development of an integrated model which includes organizational culture, KM culture and the KM process intention of the individual. Originality/value – The results-oriented, loosely controlled and job-oriented cultures will improve the effectiveness of the KM process and will also increase employees’ satisfaction and willingness to stay with the organization.

From digital citizen to digital professional

Kybernetes ◽  
2019 ◽  
Vol 48 (7) ◽  
pp. 1463-1477
Author(s):  
Olga Marino ◽  
Jaime Andres Gutierrez ◽  
Sandra Aguirre
Keyword(s):  
Information And Communication Technologies ◽  
Communication Technologies ◽  
Cutting Edge ◽  
Case Study Methodology ◽  
Content Type ◽  
Innovative Strategy ◽  
Global Issues ◽  
Wide Range ◽  
Information And Communication ◽  
Teaching Learning

Purpose This paper aims to propose and evaluate a pedagogically sound and innovative strategy to teach a higher education course that prepares future professionals to intelligently use information and communication technologies (ICTs) in their personal and professional lives. Design/methodology/approach The conceptual framework used for the design of the course was the socio-constructivism and activity theories. The implementation of the course was evaluated using the intrinsic case study methodology by including several instruments. Findings The pedagogical strategy proposed proved to be sound, as the evaluation showed that students were able to describe, use and propose innovative uses of a wide range of cutting-edge technologies in their both everyday lives and professional settings; they also had the skills to analyse the opportunities and challenges that these presented. Moreover, students liked this innovative way of learning and ended with a positive attitude towards ICT. Originality/value Although several courses prepare students to be digital citizens or use ICT to enhance the teaching-learning process, millennials are ill prepared to use cutting-edge technologies in an innovative, responsible and critical way in their future professions. The course that was designed is original in that it goes beyond preparing digital citizens to prepare professionals in any domain to use ICT in an informed and responsible way. Moreover, it is a documented, successful example of an undergraduate universal course in a highly important current society dimension. The authors believe that its pedagogical proposal could be transferred to courses dealing with other global issues such as the environment, economy and peace.

Incompressible smoothed particle hydrodynamics for MHD double-diffusive natural convection of a nanofluid in a cavity containing an oscillating pipe

2019 ◽  
Vol 30 (2) ◽  
pp. 882-917 ◽  
Author(s):  
Abdelraheem M. Aly
Keyword(s):  
Natural Convection ◽  
Smoothed Particle Hydrodynamics ◽  
Cavity Wall ◽  
Lagrangian Description ◽  
Content Type ◽  
Wide Range ◽  
Particle Hydrodynamics ◽  
Smoothed Particle ◽  
Incompressible Smoothed Particle Hydrodynamics ◽  
Double Diffusive

Purpose This paper aims to adopt incompressible smoothed particle hydrodynamics (ISPH) method to simulate MHD double-diffusive natural convection in a cavity containing an oscillating pipe and filled with nanofluid. Design/methodology/approach The Lagrangian description of the governing partial differential equations are solved numerically using improved ISPH method. The inner oscillating pipe is divided into two different pipes as an open and a closed pipe. The sidewalls of the cavity are cooled with a lower concentration C_c and the horizontal walls are adiabatic. The inner pipe is heated with higher concentration C_h. The analysis has been conducted for the two different cases of inner oscillating pipes under the effects of wide range of governing parameters. Findings It is found that a suitable oscillating pipe makes a well convective transport inside a cavity. Presence of the oscillating pipe has effects on the heat and mass transfer and fluid intensity inside a cavity. Hartman parameter suppresses the velocity and weakens the maximum values of the stream function. An increase on Hartman, Lewis and solid volume fraction parameters leads to an increase on average Nusselt number on an oscillating pipe and left cavity wall. Average Sherwood number on an oscillating pipe and left cavity wall decreases as Hartman parameter increases. Originality/value The main objective of this work is to study the MHD double-diffusive natural convection of a nanofluid in a square cavity containing an oscillating pipe using improved ISPH method.

Numerical investigation of anguilliform locomotion by the SPH method

2019 ◽  
Vol 30 (1) ◽  
pp. 328-346 ◽  
Author(s):  
Amin Rahmat ◽  
Hossein Nasiri ◽  
Marjan Goodarzi ◽  
Ehsan Heidaryan
Keyword(s):  
Drag Coefficient ◽  
Numerical Investigation ◽  
Sph Method ◽  
Content Type ◽  
Aquatic Locomotion ◽  
Wide Range ◽  
Particle Hydrodynamics ◽  
Dummy Particles ◽  
Smoothed Particle ◽  
Sph Algorithm

Purpose This paper aims to introduce a numerical investigation of aquatic locomotion using the smoothed particle hydrodynamics (SPH) method. Design/methodology/approach To model this problem, a simple improved SPH algorithm is presented that can handle complex geometries using updatable dummy particles. The computational code is validated by solving the flow over a two-dimensional cylinder and comparing its drag coefficient for two different Reynolds numbers with those in the literature. Findings Additionally, the drag coefficient and vortices created behind the aquatic swimmer are quantitatively and qualitatively compared with available credential data. Afterward, the flow over an aquatic swimmer is simulated for a wide range of Reynolds and Strouhal numbers, as well as for the amplitude envelope. Moreover, comprehensive discussions on drag coefficient and vorticity patterns behind the aquatic are made. Originality/value It is found that by increasing both Reynolds and Strouhal numbers separately, the anguilliform motion approaches the self-propulsion condition; however, the vortices show different pattern with these increments.

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