scholarly journals COVID-19: What we’ve done well and what we could or should have done better—the 4 Ps

Critical Care ◽  
2021 ◽  
Vol 25 (1) ◽  
Author(s):  
Jean-Louis Vincent ◽  
Julia Wendon ◽  
Greg S. Martin ◽  
Nicole P. Juffermans ◽  
Jacques Creteur ◽  
...  

AbstractThe current coronavirus pandemic has impacted heavily on ICUs worldwide. Although many hospitals and healthcare systems had plans in place to manage multiple casualties as a result of major natural disasters or accidents, there was insufficient preparation for the sudden, massive influx of severely ill patients with COVID-19. As a result, systems and staff were placed under immense pressure as everyone tried to optimize patient management. As the pandemic continues, we must apply what we have learned about our response, both good and bad, to improve organization and thus patient care in the future.

2018 ◽  
Author(s):  
Christian Dameff ◽  
Jordan Selzer ◽  
Jonathan Fisher ◽  
James Killeen ◽  
Jeffrey Tully

BACKGROUND Cybersecurity risks in healthcare systems have traditionally been measured in data breaches of protected health information but compromised medical devices and critical medical infrastructure raises questions about the risks of disrupted patient care. The increasing prevalence of these connected medical devices and systems implies that these risks are growing. OBJECTIVE This paper details the development and execution of three novel high fidelity clinical simulations designed to teach clinicians to recognize, treat, and prevent patient harm from vulnerable medical devices. METHODS Clinical simulations were developed which incorporated patient care scenarios with hacked medical devices based on previously researched security vulnerabilities. RESULTS Clinician participants universally failed to recognize the etiology of their patient’s pathology as being the result of a compromised device. CONCLUSIONS Simulation can be a useful tool in educating clinicians in this new, critically important patient safety space.


2018 ◽  
Vol 34 (7) ◽  
pp. 1101-1112
Author(s):  
John E Meyers

Abstract This presidential address attempts to predict the future directions of neuropsychology. Predicting the future is always a difficult thing. By examining population trends such as aging and demographics, a clearer picture becomes visible. The population is getting older and more ethnically diverse. Also, examination of the spending trends in health care indicates that neuropsychology needs to be able to adapt to working with larger population-based patient care as well as individual patient care. Shifts in the demographics of neuropsychology, in that the profession previously was 70% male dominate and now is >70% female dominant are also discussed. Trends in NAN’s speaker and leader demographics are examined as well as the need to stay current in the trends and latest neuropsychological research lest we become dinosaurs in the next 5–10 years. Recommendations for new neuropsychologists and post-doctoral fellows are also presented.


Author(s):  
Novi Noviar nurdin kasim ◽  
Imelda Meldawati Artayani

Kampung Kara’ba merupakan kampung nelayan yang ada di pesisir Kota Makassar  yang  pada kenyataannya kurang tertata dan diperhatikan. Disamping legalitas bermukim yang tidak ada, Kampung Kara'ba masuk dalam kategori rawan akan bencana alam seperti ombak pasang,  banjir, angin  puyuh dan juga  ancaman akan penggusuran yang terus meresahkan kalangan masyarakat Kara'ba, bahkan sampai pada pembangunan disekitarnya yang memaksa masyarakat nelayan Kara'ba mau tidak mau harus beralih profesi. Hal itu juga yang menyebabkan adanya wacana penataan dan perencanaan Kampung Kara'ba. Maka dari itu perlu adanya penggalian data eksisting dan aktivitas pada Kampung Nelayan Kara’ba agar nantinya bisa menjadi masukan rencana desain. Dengan menggunakan metode partisipatif atau pelibatan warga dan pihak-pihak terkait secara menyeluruh serta observasi lapangan, penulisan ini bertujuan untuk mengetahui kondisi eksisting dan aktivitas Kampung Nelayan Kara’ba. Pada pesisir pantai Makassar, terdapat berbagai macam kondisi  eksisting dan aktivitas yang dilakukan  oleh penduduk setempat maupun pengunjung. Berdasarkan analisis yang dilakukan, didapatkan hasil bahwa ada beberapa kondisi eksisting yang memungkinkan untuk dimasukkan dalam rencana perancangan Kampung Nelayan Kara’ba, tetapi ada pula yang sebaiknya dihilangkan demi terciptanya suatu rancangan bersama, yang diharapkan dapat menyelesaikan permasalahan ditingkatan warga dan tidak lagi menimbulkan permasalahan kedepannya, sehingga dari proses tersebut terciptalah hasil desain perancangan permukiman Kara'ba yang bercirikan perkampungan suku Bugis-Makassar dengan infrastruktur, fasilitas umum, sosial, dan ekonomi yang memadai,  serta penekanan hunian yang merupakan transformasi pembaharuan rumah tradisional Bugis-Makassar dengan sentuhan arsitektur neo-vernakuler. Kata kunci: permukiman nelayan, kondisi eksisting, aktivitas, partisipatif, profesi, perancangan.   Kara'ba Kampoong   is a fisherman's kampoong in cost city of Makassar which in fact unattended and   less organized. Beside of that, there is no legality settled. Kara'ba Kampoong included in the prone to natural disasters category such as tidal wave, flood, whirlwind, and also threats of evictions that make people restless, and even to the surrounding development forced the fishing community in Kara'ba to change their job.  It also  causes the arrangement discourse and planning of Kara'ba Kampoong. So, it is very important the existence of extracting fisherman kampoong, so that later can be include by design plan. By using the participative method or involving   the community and related parties overall and field observation. This writing aims to know  about  existing  condition and activities in Kara'ba Fisherman Kampoong. In cost city of Makassar, there are many kind of existing conditions which allows to be included in designing planing of Kara'ba Fisherman Kampoong, but some of them should not exist for the creation of a joint design, which is expected to solve the problems in the future, so by that process designing of Kara'ba settlement can be created which is the character of the Fisherman Kampong Bugis- Makassar with infrastruckture, public facilities, sosial, adequate economy, and four types of dwellings are tranformation of traditional house renewal Bugis-Makassar with architecture neo-vernakuler.


2021 ◽  
Author(s):  
James Brogan ◽  
Henry Goodier ◽  
Manreet Nijjar ◽  
Christian Rose

UNSTRUCTURED The current credentialing process for physicians struggled to accommodate fluctuating regional demands for providers during the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic. This hurdle highlighted existing inefficiencies and difficulties facing healthcare systems across the world and led us to explore how credentialing can be improved using digital technologies. We explain how this is a critical moment to make the shift from physical to digital credentials by specifying how a digital credentialing system could simplify onboarding for providers, enable secure expansion of telehealth services, and enhance information exchange.


Author(s):  
Adi V. Gundlapalli ◽  
Jonathan H. Reid ◽  
Jan Root ◽  
Wu Xu

A fundamental premise of continuity in patient care and safety suggests timely sharing of health information among different providers at the point of care and after the visit. In most healthcare systems, this is achieved through exchange of written medical information, phone calls and conversations. In an ideal world, this exchange of health information between disparate providers, healthcare systems, laboratories, pharmacies and payers would be achieved electronically and seamlessly. The potential benefits of electronic health exchange are improved patient care, increased efficiency of the healthcare system and decreased costs. The reality is that health information is electronically exchanged only to a limited extent within local communities and regions, much less nationally and internationally. One main challenge has been the inability of health information exchange organizations to develop a solid business case. Other challenges have been socio-political in that data ownership and stewardship have not been clearly resolved. Technological improvements over the past 20 years have provided significant advances towards safe and secure information exchange. This chapter provides a general overview of community health information exchange in the United States of America, its history and details of challenges faced by stakeholders. The lessons learned from successes and failures, research and knowledge gaps and future prospects are also discussed. Current and future technologies to facilitate and invigorate health information exchange are highlighted. Two examples of successful regional health information exchanges in the US states of Utah and Indiana are highlighted.


2020 ◽  
Vol 46 (4) ◽  
pp. 537-540 ◽  
Author(s):  
Zachary Pickell ◽  
Kathleen Gu ◽  
Aaron M Williams

Healthcare systems have postponed medical volunteering services in response to the COVID-19 pandemic. However, much of the aid provided by these volunteers is crucial to patient care and hospital functioning in the American healthcare system. The adoption of online video conferencing platforms in healthcare—telehealth—offers a novel solution for volunteering during this pandemic. Virtual volunteering can alleviate pressures on medical workers, enhance patient experiences, reduce the risk of viral infection and provide a sense of normalcy for patients and families. Although further study is required, this should be an avenue considered by health systems.


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