Improving operating room productivity via parallel anesthesia processing

2014 ◽  
Vol 27 (8) ◽  
pp. 697-706 ◽  
Author(s):  
Michael J. Brown ◽  
Arun Subramanian ◽  
Timothy B. Curry ◽  
Daryl J. Kor ◽  
Steven L. Moran ◽  
...  
Keyword(s):  
Parallel Processing ◽  
Operating Room ◽  
Upper Extremity ◽  
Regional Anesthesia ◽  
Practice Change ◽  
Care Providers ◽  
Processing Efficiency ◽  
Or Efficiency ◽  
Content Type ◽  
Efficiency And Productivity

Purpose – Parallel processing of regional anesthesia may improve operating room (OR) efficiency in patients undergoes upper extremity surgical procedures. The purpose of this paper is to evaluate whether performing regional anesthesia outside the OR in parallel increases total cases per day, improve efficiency and productivity. Design/methodology/approach – Data from all adult patients who underwent regional anesthesia as their primary anesthetic for upper extremity surgery over a one-year period were used to develop a simulation model. The model evaluated pure operating modes of regional anesthesia performed within and outside the OR in a parallel manner. The scenarios were used to evaluate how many surgeries could be completed in a standard work day (555 minutes) and assuming a standard three cases per day, what was the predicted end-of-day time overtime. Findings – Modeling results show that parallel processing of regional anesthesia increases the average cases per day for all surgeons included in the study. The average increase was 0.42 surgeries per day. Where it was assumed that three cases per day would be performed by all surgeons, the days going to overtime was reduced by 43 percent with parallel block. The overtime with parallel anesthesia was also projected to be 40 minutes less per day per surgeon. Research limitations/implications – Key limitations include the assumption that all cases used regional anesthesia in the comparisons. Many days may have both regional and general anesthesia. Also, as a case study, single-center research may limit generalizability. Practical implications – Perioperative care providers should consider parallel administration of regional anesthesia where there is a desire to increase daily upper extremity surgical case capacity. Where there are sufficient resources to do parallel anesthesia processing, efficiency and productivity can be significantly improved. Originality/value – Simulation modeling can be an effective tool to show practice change effects at a system-wide level.

Commentary on “Diabetes and people with learning disabilities: issues for policy, practice and education”

2020 ◽  
Vol 25 (1) ◽  
pp. 35-39 ◽  
Author(s):  
Brianne Redquest ◽  
Yona Lunsky
Keyword(s):  
Health Care ◽  
Learning Disabilities ◽  
Health Care Providers ◽  
Diabetes Care ◽  
Future Research ◽  
Care Providers ◽  
Family Carers ◽  
Content Type ◽  
Policy Practice

Purpose There has been an increase in research exploring the area of intellectual and developmental disabilities (IDD) and diabetes. Despite being described as instrumental to diabetes care for people with IDD, the role and experiences of family carers, such as parents and siblings, are often neglected in this research. However, it is clear that family carers do not feel that they have sufficient knowledge about diabetes. The purpose of this commentary is to extend the content from “Diabetes and people with learning disabilities: Issues for policy, practice, and education (Maine et al., 2020)” and discuss how family carers can feel better supported when caring for someone with IDD and diabetes. Design/methodology/approach This commentary discusses specific efforts such as STOP diabetes, DESMOND-ID and OK-diabetes for people with IDD including family carers. Encouragement is given for health care providers to recommend such programmes to people with IDD and their family carers. It is also suggested that health care providers involve family carers in diabetes care planning and implementation for people with IDD. Findings It is hoped that if changes are made to current diabetes practices and more research with family carers is conducted, diabetes prevention and management for people with IDD will be more successful and family carers can feel more confident in providing support to their loved ones. Originality/value Research exploring the role of family carers in diabetes care for people with IDD and diabetes is very limited. This commentary makes recommendations to help family carers feel better supported in their role. It also provides areas for future research.

Human rights-based conceptions of deservingness: health and precarity

2020 ◽  
Vol 16 (3) ◽  
pp. 279-292
Author(s):  
Sarah Marshall
Keyword(s):  
Health Care ◽  
Human Rights ◽  
Health Care Providers ◽  
Health Care Access ◽  
Migrant Health ◽  
Dominant Negative ◽  
Care Providers ◽  
Content Type ◽  
Care Access ◽  
Health Related

Purpose Ideas of health-related deservingness in theory and practise have largely been attached to humanitarian notions of compassion and care for vulnerable persons, in contrast to rights-based approaches involving a moral-legal obligation to care based on universal citizenship principles. This paper aims to provide an alternative to these frames, seeking to explore ideas of a human rights-based deservingness framework to understand health care access and entitlement amongst precarious status persons in Canada. Design/methodology/approach Drawing from theoretical conceptualizations of deservingness, this paper aims to bring deservingness frameworks into the language of human rights discourses as these ideas relate to inequalities based on noncitizenship. Findings Deservingness frameworks have been used in public discourses to both perpetuate and diminish health-related inequalities around access and entitlement. Although, movements based on human rights have the potential to be co-opted and used to re-frame precarious status migrants as “undeserving”, movements driven by frames of human rights-based deservingness can subvert these dominant, negative discourses. Originality/value To date, deservingness theory has primarily been used to speak to issues relating to deservingness to welfare services. In relation to deservingness and precarious status migrants, much of the literature focuses on humanitarian notions of the “deserving” migrant. Health-related deservingness based on human rights has been under-theorized in the literature and the authors can learn from activist movements, precarious status migrants and health care providers that have taken on this approach to mobilize for rights based on being “human”.

DEA window analysis and Malmquist index to assess efficiency and productivity in the Spanish electricity sector

2020 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Jaime Sánchez-Ortiz ◽  
Teresa Garcia-Valderrama ◽  
Vanesa Rodríguez-Cornejo ◽  
Francisca Cabrera-Monroy
Keyword(s):  
Malmquist Index ◽  
Electricity Sector ◽  
Theory Of Constraints ◽  
Economic Regulation ◽  
Data Envelopment ◽  
Electricity Distribution ◽  
Content Type ◽  
External Constraints ◽  
Efficiency And Productivity ◽  
Dea Window Analysis

Purpose The purpose of this paper is to demonstrate that overcapacity and tariff deficit (external constraints) negatively affect the efficiency of distribution firms in the Spanish electricity sector. To do this, the paper is based on the theory of constraints and theory of economic regulation. Design/methodology/approach Data envelopment analysis (DEA) window methodology is carried out on the constant scales (I-C) with a sample consisting of five main distribution firms during the period from 2006 to 2015. In turn, an analysis of the Malmquist index is carried out to assess whether it has had a displacement with respect to the efficiency frontier. Findings The results show that the overcapacity and the tariff deficit negatively affect the efficiency of the distribution firms of the Spanish electricity sector. In addition, there is an existence of external constraints that affect the activities of regulated organisations and the importance of adequate legislation in regulated sectors. Originality/value This study defines a model that shows how the efficiency problems associated with electricity distribution companies such as productive overcapacity or tariff deficit can be measured based on the theory of constraints and theory of economic regulation.

Posteroventral pallidotomy for midbrain tremor after a pontine hemorrhage

1999 ◽  
Vol 91 (5) ◽  
pp. 885-888 ◽  
Author(s):  
Yasushi Miyagi ◽  
Fumio Shima ◽  
Katsuya Ishido ◽  
Masashi Moriguchi ◽  
Kazufumi Kamikaseda
Keyword(s):  
Upper Extremity ◽  
High Frequency ◽  
Upper Extremities ◽  
Proximal Segment ◽  
Action Tremor ◽  
Content Type ◽  
Pontine Hemorrhage ◽  
Posteroventral Pallidotomy ◽  
Left Thalamus ◽  
Midbrain Tremor

✓ This 49-year-old man gradually developed a disabling action tremor in the proximal right upper extremity 8 months after suffering a pontine tegmental hemorrhage. The intraoperative microrecording in the nucleus ventralis intermedius (VIM) of the left thalamus revealed tremor-synchronous grouped discharges with a vigorous (2.7 Hz) action tremor predominantly in the shoulder and upper arm. High frequency electrical stimulation in the VIM did not affect the tremor. A posteroventral pallidotomy (PVP) was performed and resulted in the successful alleviation of all tremor activity. Posteroventral pallidotomy is known to alleviate parkinsonian tremors, especially those occurring in the contralateral lower extremity, trunk, and proximal segment of the contralateral upper extremity. The authors consider the pallidoreticular pathway to be an important tremor-mediating pathway for the proximal segment of the upper extremities and believe it can be controlled more effectively by PVP than by VIM thalamotomy, as demonstrated by the PVP-induced resolution of the midbrain tremor observed in this case.

Longitudinal evaluation of efficiency in a petrochemical company

2017 ◽  
Vol 24 (7) ◽  
pp. 1786-1813 ◽  
Author(s):  
Charles Von Gilsa ◽  
Daniel Pacheco Lacerda ◽  
Luis Felipe Riehs Camargo ◽  
Iberê Guarani Souza ◽  
Ricardo Augusto Cassel
Keyword(s):  
Learning Process ◽  
Statistical Significance ◽  
Malmquist Index ◽  
Internal Reference ◽  
Content Type ◽  
Internal Resources ◽  
Investment Projects ◽  
Actual Change ◽  
Petrochemical Company ◽  
Efficiency And Productivity

Purpose The purpose of this paper is to longitudinally assess the technical efficiency and productivity, considering investment projects and technological change, in a second-generation petrochemical company. Design/methodology/approach The study uses data envelopment analysis (DEA) together with the Malmquist index to measure efficiency during the analysis periods. The working method consists of four main phases, namely development of the conceptual model, construction of the mathematical model, application of model to the case, and analysis of the results. The study utilizes a quantitative approach with descriptive goals seeking to evaluate the impacts of technical changes on the operational efficiency and productivity of the production process. Findings The use of DEA associated with the Malmquist index proved to be viable for analyzing a single company and identifying efficiency improvements, as well as the impacts of the learning process and the implementation of improvement projects. However, the results of the improvement projects and learning process were not representative and had no statistical significance on the actual change in efficiency of the company during the periods analyzed. For the case in question, the learning process and continuous improvement were not observed during all study periods. Practical implications The proposition that the improvement projects and investments implemented increased the efficiency of the company was rejected. Hence, with this work, it was possible to determine that the company unnecessarily invested resources in projects to increase efficiency. Furthermore, the company could have explored more internal resources before making significant investments in increased efficiency. Originality/value As for the value of this research in the theoretical and academic scope, this paper advances knowledge on the application of DEA because it proposes to establish an internal reference benchmarking for comparison. The literature contains few studies that analyze organizations using continuous processes, such as petrochemical processes, in longitudinal studies as a function of time, especially with the use of DEA.

Communication and psychological safety in veterans health administration work environments

2014 ◽  
Vol 28 (6) ◽  
pp. 754-776 ◽  
Author(s):  
Nancy J. Yanchus ◽  
Ryan Derickson ◽  
Scott C. Moore ◽  
Daniele Bologna ◽  
Katerine Osatuke
Keyword(s):  
Health Care Providers ◽  
Care Delivery ◽  
Clinical Care ◽  
Psychological Safety ◽  
Veterans Health Administration ◽  
Employee Perceptions ◽  
Veterans Health ◽  
Health Administration ◽  
Care Providers ◽  
Content Type

Purpose – The purpose of this paper is to explore employee perceptions of communication in psychologically safe and unsafe clinical care environments. Design/methodology/approach – Clinical providers at the USA Veterans Health Administration were interviewed as part of planning organizational interventions. They discussed strengths, weaknesses, and desired changes in their workplaces. A subset of respondents also discussed workplace psychological safety (i.e. employee perceptions of being able to speak up or report errors without retaliation or ostracism – Edmondson, 1999). Two trained coders analysed the interview data using a grounded theory-based method. They excerpted passages that discussed job-related communication and summarized specific themes. Subsequent analyses compared frequencies of themes across workgroups defined as having psychologically safe vs unsafe climate based upon an independently administered employee survey. Findings – Perceptions of work-related communication differed across clinical provider groups with high vs low psychological safety. The differences in frequencies of communication-related themes across the compared groups matched the expected pattern of problem-laden communication characterizing psychologically unsafe workplaces. Originality/value – Previous research implied the existence of a connection between communication and psychological safety whereas this study offers substantive evidence of it. The paper summarized the differences in perceptions of communication in high vs low psychological safety environments drawing from qualitative data that reflected clinical providers’ direct experience on the job. The paper also illustrated the conclusions with multiple specific examples. The findings are informative to health care providers seeking to improve communication within care delivery teams.

Entry barriers could easily thwart China’s tech plans

2021 ◽  
Keyword(s):  
Artificial Intelligence ◽  
Quantum Computing ◽  
Import Substitution ◽  
Entry Barriers ◽  
The West ◽  
Content Type ◽  
Technological Competition ◽  
Efficiency And Productivity

Significance These are: artificial intelligence, semiconductors, quantum computing, genetics, biotechnology, neuroscience and aerospace. Impacts It is not always useful to view technological competition between China and the West as a ‘race’. China will likely burn significant capital just to achieve parity with advanced countries, and may never achieve it. Low margins will encourage protectionism and import substitution, with an impact on efficiency and productivity.

Social media as a platform for information and support for coronavirus: analysis ofCOVID-19 Facebook groups

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Hossein Motahari-Nezhad ◽  
Maryam Shekofteh ◽  
Maryam Andalib-Kondori
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Design Methodology ◽  
Information Needs ◽  
Descriptive Statistics ◽  
Public Knowledge ◽  
Care Providers ◽  
Analysis Method ◽  
Content Type ◽  
Content Analysis Method

Purpose This study aims to investigate the characteristics, as well as the purpose and posts of the COVID-19 Facebook groups. Design/methodology/approach A systematic search for COVID-19 Facebook groups was conducted on June 1, 2020. Characteristics of the groups were examined using descriptive statistics. Mann-Whitney test was used to study the differences between groups. The study of the most popular groups’ posts was also carried out using the content analysis method. Findings The groups had a combined membership of 2,729,061 users. A total of 147,885 posts were received. There were about approximately 60% public groups. A high percentage of the groups (86.5%) had descriptions. The results showed a significant relationship between the groups’ description status and the number of members (p-value = 0.016). The majority of COVID-19 Facebook groups (56%) were created to meet their members’ information needs. The highest number of studied posts were related to vaccination (35.2%), followed by curfew rules (19.6%) and symptoms (10.6%). Originality/value Translating these insights into policies and practices will put policymakers and health-care providers in a stronger position to make better use of Facebook groups to support and enhance public knowledge about COVID-19.

Upper extremity anatomy for regional anesthesia

2011 ◽  
pp. 31-36 ◽  
Author(s):  
Fernando L. Arbona ◽  
Babak Khabiri ◽  
John A. Norton
Keyword(s):  
Upper Extremity ◽  
Regional Anesthesia

scholarly journals Needs of patient with advanced stages of cancer in a Thai community

2018 ◽  
Vol 32 (5) ◽  
pp. 342-351
Author(s):  
Panita Krongyuth ◽  
Pimpan Silpasuwan ◽  
Chukiat Viwatwongkasem ◽  
Cathy Campbell
Keyword(s):  
Palliative Care ◽  
Content Analysis ◽  
Pain Management ◽  
Care Providers ◽  
Care Needs ◽  
Open Communication ◽  
Content Type ◽  
Advanced Stages ◽  
Palliative Care Needs ◽  
At Home

Purpose The purpose of this paper is to explore the needs of people with cancer in advanced stages and to analyze factors that influence them. Design/methodology/approach A concurrent mixed-method design was used. Descriptive design was conducted in Ubon Ratchathani Province, Thailand. Data were collected from a convenience sample of patients with advanced cancer of any tissue or organ. Questionnaires were completed by 110 patients aged 60 years and above (response rate 110/130=84.6 percent). In-depth interviews were conducted with a total of eight patients. Content analysis of semi-structured interviews of a sub-sample was subsequently performed to better understand the real needs of patients with advanced stages of cancer at home setting. Findings The majority (77.5 percent) reported a preference to spend their final days at home. The four most common palliative care needs were more information about disease and medical treatment (98.2 percent), more treatment for pain (97.3 percent), health education for family caregivers (95.5 percent) and health volunteers visit at home (95.5 percent). Content analysis of the qualitative data suggested that patient needs health care providers to deliver open communication, pain management and provide psychosocial supports. Originality/value The result showed that patients-related variables are associated with the palliative care needs in patients with advanced stages of cancer. Communication skills and pain management are the key components to support the need for palliative care at home and to benefit the quality of life in terminally ill patients.

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