scholarly journals Development and Evaluation of a Virtual Research Environment to Improve Quality of Care in Overcrowded Emergency Departments: Observational Study

10.2196/13993 ◽  
2019 ◽  
Vol 7 (3) ◽  
pp. e13993
Author(s):  
Charles-Henri Houze-Cerfon ◽  
Christine Vaissié ◽  
Laurent Gout ◽  
Bruno Bastiani ◽  
Sandrine Charpentier ◽  
...  
Keyword(s):  
Emergency Medicine ◽  
Quality Of Care ◽  
Observational Study ◽  
Emergency Physicians ◽  
Research Environment ◽  
Wide Range ◽  
Significant Difference ◽  
Ed Overcrowding ◽  
Virtual Research Environment

Background Despite a wide range of literature on emergency department (ED) overcrowding, scientific knowledge on emergency physicians’ cognitive processes coping with overcrowding is limited. Objective This study aimed to develop and evaluate a virtual research environment that will allow us to study the effect of physicians’ strategies and behaviors on quality of care in the context of ED overcrowding. Methods A simulation-based observational study was conducted over two stages: the development of a simulation model and its evaluation. A research environment in emergency medicine combining virtual reality and simulated patients was designed and developed. Afterwards, 12 emergency physicians took part in simulation scenarios and had to manage 13 patients during a 2-hour period. The study outcome was the authenticity of the environment through realism, consistency, and mastering. The realism was the resemblance perceived by the participants between virtual and real ED. The consistency of the scenario and the participants’ mastering of the environment was expected for 90% (12/13) of the participants. Results The virtual ED was considered realistic with no significant difference from the real world with respect to facilities and resources, except for the length of time of procedures that was perceived to be shorter. A total of 100% (13/13) of participants deemed that patient information, decision making, and managing patient flow were similar to real clinical practice. The virtual environment was well-mastered by all participants over the course of the scenarios. Conclusions The new simulation tool, Virtual Research Environment in Emergency Medicine, has been successfully designed and developed. It has been assessed as perfectly authentic by emergency physicians compared with real EDs and thus offers another way to study human factors, quality of care, and patient safety in the context of ED overcrowding.

scholarly journals How to improve quality of care in overcrowded emergency departments? Development and evaluation of a virtual research environment. (Preprint)

2019 ◽  
Author(s):  
Charles-Henri Houze Cerfon ◽  
Christine Vaissié ◽  
Laurent Gout ◽  
Bruno Bastiani ◽  
Sandrine Charpentier ◽  
...  
Keyword(s):  
Emergency Department ◽  
Emergency Medicine ◽  
Quality Of Care ◽  
Simulated Patients ◽  
Emergency Physicians ◽  
Research Environment ◽  
Significant Difference ◽  
Ed Overcrowding ◽  
Virtual Research Environment

BACKGROUND Despite wide literature on ED overcrowding, scientific knowledge on emergency physicians’ cognitive processes coping with overcrowding is limited. OBJECTIVE We sought to develop and evaluate a virtual research environment that will allow us to study the effect of physicians’ strategies and behaviours on quality of care in the context of emergency department overcrowding. METHODS A simulation-based observational study was conducted over two stages: the development of a simulation model and its evaluation. A research environment in Emergency Medicine combining virtual reality and simulated patients has been designed and developed. Then, twelve emergency physicians took part in simulation scenarios and had to manage thirteen patients during a 2-hour period. The study outcome was the authenticity of the environment through realism, consistency and mastering. The realism was the resemblance perceived by the participants between virtual and real Emergency Department. The consistency of the scenario and the participants’ mastering of the environment was expected for 90% of the participants. RESULTS The virtual emergency department was considered realistic with no significant difference from the real world concerning facilities and resources except for the length of time of procedures that was perceived to be shorter. 100% of participants deemed that patient information, decision-making and managing patient flow were similar to real clinical practice. The virtual environment was well-mastered by all participants over the course of the scenarios. CONCLUSIONS The new simulation tool, Virtual Research Environment in Emergency Medicine has been successfully designed and developed. It has been assessed as perfectly authentic by emergency physicians compared to real EDs and thus offers another way to study human factors, quality of care and patient safety in the context of ED overcrowding.

scholarly journals Perceived quality of care among people with type 2 diabetes mellitus in the north east region of peninsular Malaysia

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Noorfariza Nordin ◽  
Suhaily Mohd Hairon ◽  
Najib Majdi Yaacob ◽  
Anees Abdul Hamid ◽  
Seoparjoo Azmel Mohd Isa ◽  
...  
Keyword(s):  
Quality Of Care ◽  
Perceived Quality ◽  
Peninsular Malaysia ◽  
North East ◽  
The North ◽  
East Region ◽  
Perceived Quality Of Care ◽  
Significant Difference

Abstract Background People with type 2 diabetes mellitus (T2DM) are best managed by a chronic care model that is associated with enhanced quality of care and improved patient outcome. Assessing patients’ perceived quality of care is crucial in improving the healthcare delivery system. Hence, this study determined the perceived quality of care among people with T2DM and explored its associations with (i) sociodemographic and clinical characteristics and (ii) types of healthcare clinics to guide future planning. Methods A cross-sectional study involving 20 primary healthcare clinics in the North East Region of Peninsular Malaysia and people with T2DM as the sampling unit was conducted from February to May 2019. The pro forma checklist, interview-guided Skala Kepuasan Interaksi Perubatan-11, and Patient Assessment of Chronic Illness Care (Malay version; PACIC-M) questionnaire were used for data collection. Univariate analysis and linear regression were used to determine the status of perceived quality of care and the factors associated with the perceived quality of care, respectively. Results Overall, data from 772 participants were analyzed. The majority was from the Malay ethnic group (95.6%) with a mean (standard deviation [SD]) glycated hemoglobin A1c (HbA1c) level of 8.91% (2.30). The median (interquartile range [IQR]) of the number of medical officers available at each clinic was 6 (7), with Family Doctor Concept (FDC) clinics having a higher number of medical officers than non-FDC clinics (p = 0.001). The overall mean (SD) PACIC-M score was 2.65 (0.54) with no significant difference between scores of patients treated in the two clinic types (p = 0.806). Higher perceived quality of care was associated with lower number of medical officers (adjusted regression coefficient [Adj.β], − 0.021; p-value [p], 0.001), and greater doctor–patient interaction in all domains: distress relief (Adj.β, 0.033; p, < 0.001), rapport (Adj.β, 0.056; p, < 0.001), and interaction outcome (Adj.β, 0.022; p, 0.003). Conclusion Although there was no significant difference found between clinic type, this study reflects that patients are comfortable when managed by the same doctor, which may support a better doctor-patient interaction. A larger specialized primary care workforce could improve diabetes care in Malaysia.

scholarly journals Predictors of the quality of care for asthma in general practice: an observational study

2009 ◽  
Vol 27 (2) ◽  
pp. 186-191 ◽  
Author(s):  
A. S Abdelhamid ◽  
S. Maisey ◽  
N. Steel
Keyword(s):  
General Practice ◽  
Quality Of Care ◽  
Observational Study

scholarly journals Recorded quality of care for depression in general practice: an observational study

2009 ◽  
Vol 59 (559) ◽  
pp. e32-e37 ◽  
Author(s):  
Sivatharan Vedavanam ◽  
Nicholas Steel ◽  
Joanne Broadbent ◽  
Susan Maisey ◽  
Amanda Howe
Keyword(s):  
General Practice ◽  
Quality Of Care ◽  
Observational Study

VirES for Swarm & Virtual Research Environment: Software, guides & infrastructure to boost accessibility of Swarm

2021 ◽  
Author(s):  
Ashley Smith ◽  
Martin Pačes
Keyword(s):  
Community Involvement ◽  
Geomagnetic Field ◽  
Data Retrieval ◽  
Product Portfolio ◽  
It Services ◽  
Research Environment ◽  
Wide Range ◽  
Geomagnetic Field Models ◽  
Virtual Research Environment ◽  
Model Residuals

&lt;p&gt;ESA's Swarm mission continues to deliver excellent data providing insight into a wide range of geophysical phenomena. The mission is an important asset whose data are used within a number of critical resources, from geomagnetic field models to space weather services. As the product portfolio grows to better deliver on the mission's scientific goals, we face increasing complexity in accessing, processing, and visualising the data and models. ESA provides &amp;#8220;VirES for Swarm&amp;#8221; [1] (developed by EOX IT Services) to help solve this problem. VirES is a web-based data retrieval and visualisation tool where the majority of Swarm products are available. VirES has a graphical interface but also a machine-to-machine interface (API) for programmable use (a Python client is provided). The VirES API also provides access to geomagnetic ground observatory data, as well as forwards evaluation of geomagnetic field models to give data-model residuals. The &quot;Virtual Research Environment&quot; (VRE) adds utility to VirES with a free cloud-based JupyterLab interface allowing scientists to immediately program their own analysis of Swarm products using the Python ecosystem. We are augmenting this with a suite of Jupyter notebooks and dashboards, each targeting a specific use case, and seek community involvement to grow this resource.&lt;/p&gt;&lt;p&gt;[1] https://vires.services&lt;/p&gt;

scholarly journals P012: Québec emergency physicians propose priority solutions to improve rural emergency care

CJEM ◽  
2017 ◽  
Vol 19 (S1) ◽  
pp. S81-S82
Author(s):  
J. Audet ◽  
L. Lapointe ◽  
M. Renaud ◽  
C. Turgeon-Pelchat ◽  
B. Mathieu ◽  
...  
Keyword(s):  
Quality Of Care ◽  
Rural Areas ◽  
Annual Conference ◽  
Staff Retention ◽  
Emergency Physicians ◽  
Three Solutions ◽  
Rural Regions ◽  
Priority Level ◽  
Targeted Ultrasound

Introduction: In the province of Québec, roughly 20% of the population lives in rural areas. Rural emergency departments (EDs) face different challenges than their urban counterparts. Yet, few studies have sought to understand these challenges. This study aims to survey Québec’s emergency physicians to: 1) identify problems specific to rural EDs, 2) find solutions for improving accessibility and quality of care offered in rural regions and, 3) rank solutions in order of priority. These results will allow data triangulation with other of our studies that seek to identify challenges faced by rural EDs and potential solutions. Methods: During the 2016 annual conference of the Québec Emergency Physicians’ Association, we asked physicians and residents (including those from urban EDs), to complete a survey about the challenges faced by rural EDs. The survey contained two sections. The first took the form of open-ended questions in which respondents could write three challenges about accessibility and quality of care in rural EDs (objective 1) and three solutions to address these challenges (objective 2). The second section listed 11 potential solutions identified in our previous study. The solutions were ranked based on their priority level on a five-point Likert scale that ranged from “not a priority” to “an absolute priority” (objective 3). We added the total number of points for each solution and produced a ranking list. Results: Ninety-one physicians out of the 417 at the conference completed the survey; 58% came from urban EDs and 42% from rural EDs. Open-ended questions suggest that access to specialists and interfacility transfers are the principal challenges faced by rural EDs. The top five solutions identified as the highest priorities were: 1) care protocols, 2) improvement of interfacility transfers, 3) training with simulators, 4) targeted ultrasound and, 5) implementation of staff retention and recruitment strategies. Conclusion: This study is relevant and useful as roughly a quarter of attendants at the conference spontaneously volunteered to help identify and prioritize solutions to foster the accessibility and quality of care in rural EDs. Furthermore, it represents a stepping stone for our recently-launched wide-scope study, Urgences Rurales 360, that aims to explore problems faced by every of the 28 rural EDs in Québec and the solutions that could be implemented to resolve them.

Improving quality of care by obtaining patient-reported outcomes (PRO)-CTCAE chemotoxicities using tablet technology in daycare (DC) waiting rooms.

2014 ◽  
Vol 32 (30_suppl) ◽  
pp. 165-165 ◽  
Author(s):  
Tian Qi Wang ◽  
Catherine Brown ◽  
Ashlee Vennettilli ◽  
Lauren Wong ◽  
Aein Zarrin ◽  
...  
Keyword(s):  
Quality Of Care ◽  
Time Frame ◽  
Patient Reported Outcome ◽  
Waiting Room ◽  
Cross Sectional ◽  
Hematologic Cancer ◽  
Wide Range ◽  
Patient Reported ◽  
Age Range

165 Background: In a busy chemo DC, any efficient means of tracking important chemotoxicities can improve quality of care. The study goal was to evaluate whether tablet technology available in a DC waiting room is able to capture prevalent and severe toxicities associated with chemotherapy using the patient reported outcome (PRO) - common toxicity criteria for adverse events (CTCAE). Methods: This cross-sectional PRO-CTCAE study of 160 adult solid/hematologic cancer outpatients of all stages, who were undergoing chemotherapy (CT), focused on common chemotoxicities captured using touchscreen tablets in the DC waiting room of Princess Margaret Cancer Centre (Toronto, CA). Individual health scores from the EQ-5D VAS tool and the prevalence of AEs experienced by cancer patients within the past seven days were captured. Symptoms that were listed as moderate to very severe were considered significant. Results: Across a wide range of tumours and patients on intravenous CT, the median age (range) was 56 (19-88) years; 38% were males.Patients reported a median (range) health score (100 = best health possible, 0 = worst) of 70 (4-100). The severity offiveprevalent, key side-effects of CT were tabulated (Table). 59% of patients felt their fatigue interfered significantly with their daily activities, and 30% felt decreased appetite interfered significantly. 32% experienced nausea occasionally to almost constantly. Conclusions: The common symptoms of CT were captured FEASIBLY, and found to be highly prevalent in this CT-treated population. Capturing additional symptom prevalence outside of the 7-day time frame may be important from a clinical standpoint. Administration of PRO-CTCAE instrument through tablet technology may be an excellent method to help collect such data systematically and reliably. Updated data on 300 patients will be presented at the meeting. [Table: see text]

Quality of Life in People With Severe Dementia and Its Association With the Environment in Nursing Homes: An Observational Study

2018 ◽  
Vol 59 (4) ◽  
pp. 665-674 ◽  
Author(s):  
Rebecca Palm ◽  
Diana Trutschel ◽  
Christian G G Sorg ◽  
Martin N Dichter ◽  
Burkhard Haastert ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Nursing Homes ◽  
Observational Study ◽  
Nursing Home Residents ◽  
Theoretical Models ◽  
Annual Data ◽  
Significant Interaction Effect ◽  
Significant Difference ◽  
Diagnosis Of Dementia

Abstract Background and Objectives Theoretical models propose the environment as a factor influencing the quality of life (QoL) of nursing home residents with dementia. This study investigates whether the observed QoL differs depending on the type of care unit. Research Design and Methods DemenzMonitor is an exploratory, observational study involving annual data collection in German nursing homes (2012–2014). For this analysis, we selected residents with a recorded diagnosis of dementia and severe cognitive impairment. QoL was measured with the proxy assessment QUALIDEM. Four care unit types were investigated: large integrated, large segregated, small integrated, and small segregated. Results We did not find a significant difference between the care units. During the 2 years, the observed QoL was not affected by any of the care unit types in a statistically significant or clinically relevant manner. However, a significant interaction effect between time and care unit types was found. Discussion and Implications Structural and organizational characteristics of care units, which in turn have implications for residents characteristics and the quality of care, may influence the QoL of residents. This may explain the interaction we observed.

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