The Impact of an Automated Dispensing System for Supplying Narcotics in a Surgical Unit: The Experience of the National Cancer Institute Foundation of Milan

2018 ◽  
Vol 54 (5) ◽  
pp. 335-342 ◽  
Author(s):  
Giulia Portelli ◽  
Michela Canobbio ◽  
Rossella Bitonti ◽  
Chiara Della Costanza ◽  
Roberto Langella ◽  
...  
Keyword(s):  
National Cancer Institute ◽  
Hospital Costs ◽  
Added Value ◽  
Staff Time ◽  
Economic Saving ◽  
Before And After ◽  
Average Operating ◽  
The Impact ◽  
Surgical Unit ◽  
Narcotic Drugs

Objective: An automated dispensing system for narcotic drugs was introduced in a surgical unit to be compliant with the Italian narcotic drugs regulation. The aim of this study was to evaluate the impact of this automated dispensing system on the incidence of registry errors and corrections and on staff time and hospital costs. Methods: In 2014, Pyxis MedStation 3500 was introduced in a surgical unit of the National Cancer Institute of Milan, to improve the effectiveness of narcotics dispensing and avoid potential errors. Two different time periods of 8 months were compared, respectively, before and after the introduction of the automated dispensing system. In the pre-Pyxis period, drug movements were recorded through paper registries, while in the post-Pyxis period, electronic reports were automatically created from the system. For each period, the number of load/unload registry entries and corrections, the number of registry errors, the staff time dedicated to dispensing and registry activities, and stock and expired drug quantities were recorded. Results: Load and unload errors were reduced by 100% from the pre-Pyxis period to the post-Pyxis period, while registry corrections were lowered by 95%. Time dedicated from nurses to dispensing registration activities was reduced from 36 to 2 hours/month, while pharmacist time lowered from 9 to 1 hours/month. These time savings correspond to an economic saving of ~€4,120 and ~€3,730, respectively. In the post-Pyxis period, average operating room stock quantities were reduced versus the pre-Pyxis period, with wastage being 100% avoided. The reduction in stock drug quantities could correspond to an economic saving of ~€22,300 over the examined 8-month period, while the impact of drug wastage avoidance is modest (~€650). Conclusion: The overall economic impact of Pyxis use, over the 8-month time horizon in analysis, was around €31,000 saved or possibly converted into resource cost dedicated to other added value activities.

Investigating the effects of COVID-19 to crime rates through a geospatial approach: the case of New York, USA

2021 ◽  
Author(s):  
Ioanna Tselka ◽  
Isidora Isis Demertzi ◽  
George P. Petropoulos
Keyword(s):  
New York ◽  
Scientific Evidence ◽  
Cost Effective ◽  
Crime Rates ◽  
Added Value ◽  
Web Gis ◽  
Study Region ◽  
Cost Effective Approach ◽  
Before And After ◽  
The Impact

<p>Covid-19 pandemic has led to severe consequences to humanity worldwide. Yet, to our knowledge, little scientific evidence is available exploring the impact of the pandemic on criminality. Thus, it is imperative to examine their relationships spatially to obtain a better understanding of societal characteristics during the pandemic.</p><p>This study aims at demonstrating the use of geoinformation in analyzing the spatial patterns between crime properties and Covid-19 spread using as a case study New York City, USA, one of the largest metropolitan cities of the world. To address our objectives, geostatistical analysis and data visualization methods have been implemented in real-world crime data acquired from a web-GIS platform. Our analysis concerns two equal time periods before and after the lockdown implementation.</p><p>Results revealed some very interesting patterns spatially between the examined parameters and societal characteristics existing in the study region. The methodological framework presented underlined the added value of geoinformation as a robust and cost-effective approach in examining the impact of the pandemic to the society.</p><p> </p><p><strong>Keywords:</strong> Covid-19, pandemic, crime rates, geoinformation, New York</p>

scholarly journals Impact of a dedicated emergency surgical unit on early laparoscopic cholecystectomy for acute cholecystitis

2016 ◽  
Vol 98 (2) ◽  
pp. 107-115 ◽  
Author(s):  
S Bokhari ◽  
U Walsh ◽  
K Qurashi ◽  
L Liasis ◽  
J Watfah ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Acute Cholecystitis ◽  
Best Practice ◽  
District General Hospital ◽  
Emergency General Surgery ◽  
Early Laparoscopic Cholecystectomy ◽  
Before And After ◽  
One Year ◽  
The Impact ◽  
Surgical Unit

Introduction Emergency general surgery (EGS) accounts for 50% of the surgical workload, and yet outcomes are variable and poorly recorded. The management of acute cholecystitis (AC) at a dedicated emergency surgical unit (ESU) was assessed as a performance target for EGS. Methods The outcomes for AC admissions were compared one year before and after inception of the ESU. The impact on cost and compliance with national guidance recommending early laparoscopic cholecystectomy (ELC) within seven days of diagnosis was assessed. Results The overall ELC rate increased from 26% for the 126 patients admitted in the pre-ESU period to 45% for the 152 patients admitted in the post-ESU period (p=0.001). With those unsuitable for ELC excluded, the ELC rate increased from 34% to 82% (p<0.001). The proportion of patients precluded from ELC for avoidable reasons, particularly owing to ‘surgeon preference/skill’, was reduced from 69% to 18% (p<0.001). The mean total length of stay (LOS) and postoperative LOS fell by 1.7 days (from 8.3 to 6.6 days, p=0.040) and 2 days (from 5.6 to 3.6 days, p=0.020) respectively. The higher ELC rate and the reduction in LOS produced additional tariff income (£111,930) and estimated savings in bed day (£90,440) and readmission (£27,252) costs. Conclusions A dedicated ESU incorporating national recommendations for EGS improves alignment of best practice with best evidence and can also result in financial rewards for a busy district general hospital.

scholarly journals Reduction in Varicose Vein Services: Impact on Operative Training

2007 ◽  
Vol 89 (8) ◽  
pp. 789-791 ◽  
Author(s):  
A Bajwa ◽  
TR Magee ◽  
RB Galland
Keyword(s):  
Varicose Vein ◽  
Primary Care Trust ◽  
District General Hospital ◽  
Work Load ◽  
Middle Grade ◽  
Case Load ◽  
Before And After ◽  
Local Primary Care ◽  
The Impact ◽  
Surgical Unit

INTRODUCTION This study examines the impact of rationing varicose vein operations on operative training on a general surgical unit with a vascular interest. PATIENTS AND METHODS Log-books of middle-grade surgeons were analysed for 3-month periods before and after a decision by the local Primary Care Trust to ration varicose vein referrals. Number, intermediate equivalents and type of operations were recorded, whether they were general or vascular cases and whether the trainee had carried out or assisted with the operation. RESULTS There was a slight fall in the total number of operations in which the middle-grade surgeons were involved (208 to 186). There was a significant increase in general surgical cases with the fall in number of varicose vein operations (P < 0.0001).The fall in case-load and work-load operative training in vascular surgery was compensated by an increase in general surgical cases (P = 0.0003). This was largely due to increased number of hernia repairs (P = 0.0035). CONCLUSIONS From the point of operative training, a vascular unit in a district general hospital would not be sustainable following withdrawal of varicose vein services. However, this can be off-set by increasing general surgical case-load to fill the gap created.

scholarly journals Implementation of a novel emergency surgical unit significantly improves the management of gallstone pancreatitis

2015 ◽  
Vol 97 (4) ◽  
pp. 308-314 ◽  
Author(s):  
S Bokhari ◽  
M Kulendran ◽  
L Liasis ◽  
K Qurashi ◽  
M Sen ◽  
...  
Keyword(s):  
Emergency Surgery ◽  
District General Hospital ◽  
British Society ◽  
Gallstone Pancreatitis ◽  
Before And After ◽  
The Mean ◽  
Comparative Audit ◽  
The Impact ◽  
Surgical Unit ◽  
Definitive Management

Introduction Emergency surgery is changing rapidly with a greater workload, early subspecialisation and centralisation of emergency care. We describe the impact of a novel emergency surgical unit (ESU) on the definitive management of patients with gallstone pancreatitis (GSP). Methods A comparative audit was undertaken for all admissions with GSP before and after the introduction of the ESU over a six-month period. The impact on compliance with British Society of Gastroenterology (BSG) guidelines was assessed. Results Thirty-five patients were treated for GSP between December 2013 and May 2014, after the introduction of the ESU. This was twice the nationally reported average for a UK trust over a six-month period. All patients received definitive management for their GSP and 100% of all suitable patients received treatment during the index admission or within two weeks of discharge. This was a significantly greater proportion than that prior to the introduction of the ESU (57%, p=0.0001) as well as the recently reported national average (34%). The mean length of total inpatient stay was reduced significantly after the ESU was introduced from 13.7 ± 4.7 days to 7.8 ± 2.1 days (p=0.03). The mean length of postoperative stay also fell significantly from 6.7 ± 2.6 days to 1.8 ± 0.8 days (p=0.001). Conclusions A dedicated ESU following national recommendations for emergency surgery care by way of using dedicated emergency surgeons and a streamlined protocol for common presentations has been shown by audit of current practice to significantly improve the management of patients presenting to a busy district general hospital with GSP.

scholarly journals 2513

2017 ◽  
Vol 1 (S1) ◽  
pp. 51-51
Author(s):  
Michelle Lamere ◽  
Angela Merrifield ◽  
Deborah Hendricks ◽  
Megan Hoffman ◽  
Megan Larson ◽  
...  
Keyword(s):  
Community Engagement ◽  
Poster Presentation ◽  
Workforce Development ◽  
Poster Session ◽  
Ethical Issues ◽  
Added Value ◽  
Future Assessment ◽  
Before And After ◽  
The Impact

OBJECTIVES/SPECIFIC AIMS: The 2 primary objectives were to (i) insure that Scholars can effectively communicate the translational impact of their research to a lay audience and (ii) assess the benefits and efficacy of having community, as well as faculty members, judge the translational impact of KL2 Scholar’s poster presentations. An explicit secondary goal was to further the engagement of community members in CTSI-sponsored translational research. METHODS/STUDY POPULATION: CTSI’s Education, Community Engagement, Discovery and Translation, and Translational Workforce Development Cores created the translational impact questions and evaluation sheets. The Community Engagement and Office of Discovery and Translation recruited community judges from their respective networks and they were assigned to relevant studies. Scholars were provided with the judges scoring template in advance. After the Research Poster Session, the KL2 Scholars evaluated the quality of their presentations and the impact of having feedback from Community Judges. The Community Judges evaluated their perceived “added value” to the research presentations and their interactions with the Scholars. Both Scholars and judges completed evaluations of the poster presentation and judging process, performed on a 5-point Likert scale. RESULTS/ANTICIPATED RESULTS: KL2 Scholars felt that the community impact judges provided valuable feedback on their research (3.8/5) and were satisfied overall with the poster session (3.4/5). In evaluating their own presentations, Scholars tended to rate themselves higher (4.2–4.6/5) on the clarity of their translational impact presentations than the community judges rated the Scholars (4.1–4.2/5). Scholars also rated themselves somewhat higher in the quality of their dealing with any ethical issues and their dissemination plan (4.0/5) than the community judges (3.8/5). Judges were very positive and felt they brought value to the experience (4.2–4.4/5). DISCUSSION/SIGNIFICANCE OF IMPACT: Community judges added qualitative value to the Scholar presentations based on the Scholar and community judge evaluations and based on comparison based on prior year poster sessions. Documenting the degree of impact of the combination of this proscribed poster format and community-judging process awaits future assessment of Scholar presentations before and after the next annual poster presentation.

The Added Value of Infrared Thermography to Assess the Impact Performance of Composites

2017 ◽  
Vol 1 (2) ◽  
Author(s):  
Simone Boccardi ◽  
Natalino D. Boffa ◽  
Giovanni M. Carlomagno ◽  
Carosena Meola ◽  
Fabrizio Ricci ◽  
...  
Keyword(s):  
Composite Materials ◽  
Nondestructive Evaluation ◽  
Infrared Thermography ◽  
Added Value ◽  
Manufacturing Defects ◽  
Impact Performance ◽  
Before And After ◽  
New Material ◽  
Lock In ◽  
The Impact

Composite materials are becoming ever more popular in an increasing number of applications. This because of their many advantages, amongst others the possibility to create a new material of given characteristics in a quite simple way by changing either the type of matrix, or reinforcement, and/or rearranging the reinforcement in a different way. Of course, once a new material is created, it is necessary to characterize it to verify its suitability for a specific exploitation. In this context, infrared thermography (IRT) represents a viable means since it is noncontact, nonintrusive, and can be used either for nondestructive evaluation to detect manufacturing defects, or fatigue-induced degradation, or else for monitoring the inline response to applied loads. In this work, IRT is used to investigate different types of composite materials, which involve carbon fibers embedded in a thermoset matrix and either glass or jute fibers embedded in a thermoplastic matrix, which may be neat, or modified by the addition of a percentage of a specific compatibilizing agent. IRT is used with a twofold function. First, for nondestructive evaluation, with the lock-in technique, before and after loading to either assure absence of manufacturing defects, or discover the damage caused by the loads. Second, for visualization of thermal effects, which develop when the material is subjected to impact. The obtained results show that it is possible to follow inline what happens to the material (bending, delamination, and eventual failure) under impact and get information, which may be valuable to deepen the complex impact damaging mechanisms of composites.

Strategic Role of Zakat in Multidimensional Quality of Life in Sijunjung, Indonesia

2018 ◽  
Vol 15 (1) ◽  
pp. 55-72
Author(s):  
Herlin Hamimi ◽  
Abdul Ghafar Ismail ◽  
Muhammad Hasbi Zaenal
Keyword(s):  
Quality Of Life ◽  
Positive Impact ◽  
Wealth Distribution ◽  
Absolute Poverty ◽  
Before And After ◽  
The Status ◽  
Being There ◽  
The Impact

Zakat is one of the five pillars of Islam which has a function of faith, social and economic functions. Muslims who can pay zakat are required to give at least 2.5 per cent of their wealth. The problem of poverty prevalent in disadvantaged regions because of the difficulty of access to information and communication led to a gap that is so high in wealth and resources. The instrument of zakat provides a paradigm in the achievement of equitable wealth distribution and healthy circulation. Zakat potentially offers a better life and improves the quality of human being. There is a human quality improvement not only in economic terms but also in spiritual terms such as improving religiousity. This study aims to examine the role of zakat to alleviate humanitarian issues in disadvantaged regions such as Sijunjung, one of zakat beneficiaries and impoverished areas in Indonesia. The researcher attempted a Cibest method to capture the impact of zakat beneficiaries before and after becoming a member of Zakat Community Development (ZCD) Program in material and spiritual value. The overall analysis shows that zakat has a positive impact on disadvantaged regions development and enhance the quality of life of the community. There is an improvement in the average of mustahik household incomes after becoming a member of ZCD Program. Cibest model demonstrates that material, spiritual, and absolute poverty index decreased by 10, 5, and 6 per cent. Meanwhile, the welfare index is increased by 21 per cent. These findings have significant implications for developing the quality of life in disadvantaged regions in Sijunjung. Therefore, zakat is one of the instruments to change the status of disadvantaged areas to be equivalent to other areas.

ANALISIS PENGARUH PEMBANGUNAN JALAN LAYANG JANTI TERHADAP PERKEMBANGAN TATA RUANG KAWASAN JANTI STUDI KASUS : KAWASAN JANTI, DESA CATURTUNGGAL, KABUPATEN SLEMAN, D. I. YOGYAKARTA

2017 ◽  
Vol 11 (3) ◽  
pp. 255
Author(s):  
Jeky El Boru
Keyword(s):  
Road Network ◽  
Open Space ◽  
Qualitative Description ◽  
Analysis Method ◽  
Open Spaces ◽  
The Road ◽  
Before And After ◽  
Linkage Method ◽  
The Impact ◽  
Parking Place

Abstract: This research aims to analyze the impact of Janti Flyover Construction toward the growth of layout at Janti Urban Area, including structured space, open space, and linkage. Method used for data collecting are observation, air photograph monitoring, and interview, whereas the analysis method is qualitative description, which is the superimposed method of two layers, that are the layout condition before and after flyover construction. The result shows that the impact of Janti Flyover construction can be seen on building mass (solid), the increasing number of open spaces, including the road network, parking place, and park, whereas the relation between spaces, visually and structurally, can be seen on the growth of buildings which have new shapes and styles, therefore the performance of the overall building does not have a proportional shape. Considering Janti Street at the collective relation, its role is getting stronger as the main frame road network.Keywords: Flyover construction, layout changing, Janti AreaAbstrak: Penelitian ini bertujuan untuk menganalisis pengaruh pembangunan Jalan Layang Janti terhadap perkembangan tata ruang Kawasan Janti, meliputi ruang terbangun, ruang terbuka, serta hubungan antar ruang (“linkage”). Metode pengumpulan data dilakukan melalui observasi, pengamatan foto udara, dan wawancara; sedangkan metode analisis melalui deskripsi secara kualitatif yang berupa “superimposed method” dari dua lapisan kondisi lahan, yakni kondisi tata ruang sebelum dan sesudah pembangunan jalan layang. Hasil penelitian menunjukkan bahwa pengaruh pembangunan Jalan Layang Janti terdapat pada massa bangunan (“solid”), pertambahan ruang terbuka yang berupa jaringan jalan, parkir, dan taman; sedangkan pada hubungan antar ruang ̶ secara visual dan struktural ̶ yakni tumbuhnya bangunan dengan bentuk dan gaya baru, sehingga bentuk tampilan bangunan secara keseluruhan tidak proporsional. Pada hubungan kolektif, Jalan Janti semakin kuat perannya sebagai kerangka utama jaringan jalan.Kata kunci : Pembangunan jalan layang, tata ruang, Kawasan Janti

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