scholarly journals A Mobile-Based Patient-Centric Passive System for Guiding Patients Through the Hospital Workflow: Design and Development (Preprint)

2019 ◽  
Author(s):  
Chalee Vorakulpipat ◽  
Ekkachan Rattanalerdnusorn ◽  
Soontorn Sirapaisan ◽  
Visut Savangsuk ◽  
Natsuda Kasisopha
Keyword(s):  
Hospital Staff ◽  
Medium Size ◽  
Hospital Data ◽  
Patient Centered ◽  
Staff Members ◽  
Additional Information ◽  
Wireless Communication Network ◽  
High Investment ◽  
Self Service ◽  
Set Up

BACKGROUND A hospital is an unfamiliar place to patients because of its style, atmosphere, and procedures. These hospital characteristics cause patients to become confused about responding to protocols, which slows down the procedural flows. Some additional information technology infrastructure facilities and human resources may be needed to solve these problems. However, this solution needs high investment and cannot guarantee an accuracy of information sent to patients. To handle this limitation, EasyHos has been developed to help patients recognize their status (for example, “waiting for an appointment at 11am“) during their stay in a hospital using all existing infrastructure and hospital data and without changing existing hospital's process. OBJECTIVE The objective of this study was to provide a design of the EasyHos system and the case study in hospitals in Thailand. The design is usable and repeatable for small- and medium-sized hospitals where internet infrastructure is in place. METHODS The EasyHos system has been designed based on existing infrastructure, hospital data and hospital processes. The main components include mobile devices, existing hospital data, wireless communication network. The EasyHos was deployed at 2 hospitals in Thailand, one small and the other with a medium size. The experimental process was focused on solving the problem of unfamiliarity in the hospital. The criteria and pretest conditions regarding the unexpected problem have been defined before the experiment. RESULTS The results are presented in terms of criteria, pretest conditions, posttest conditions in the hospitals. The posttest conditions show the experimental results and impact of the system on users such as hospital nurses/staff and patients. For example, the questions from patients were reduced by 83.3% after using EasyHos system while nurses/hospital staff had 5 min more to do their routine work each day. In addition, another impact is that hospitals can create new information values from existing data, which now can be visible and valuable to patients. CONCLUSIONS Hospitals' unexpected problems have been reduced by the EasyHos system. The EasyHos system has been developed with self-service and patient-centered concepts to assist patients with necessary information. The system makes interaction easier for nurses/hospital staff members and patients working or waiting in the hospital. The nurses/hospital staff members would have more time to do their routine works. Hospitals can easily set up the EasyHos system, which will have a low or nearly zero implementation cost.

scholarly journals The New Normal of ENT OPD - Adapting Safe Practices.

2020 ◽  
Author(s):  
Aditya Yeolekar ◽  
Sudhir Bhalerao ◽  
Maya Bhalerao
Keyword(s):  
Healthcare Workers ◽  
High Viral Load ◽  
Hospital Staff ◽  
Staff Members ◽  
Contingency Plans ◽  
Practice Plan ◽  
Cross Transmission ◽  
Small Set ◽  
Set Up ◽  
Transmission Of Disease

Abstract The COVID-19 epidemic originating in China has spread rapidly worldwide and converted to pandemic proportions in March 2020. In India and densely populated countries like Brazil and USA the numbers are still rising. Clinicians all over the world are trying to contain it by minimizing the cross-transmission of disease among hospital staff members. In the field of Otorhinolaryngology (ENT) the doctors are exposed to high viral load while examining the patients. Therefore contingency plans are required for dealing with patients in outpatient clinics, and while performing diagnostic endoscopies, minor procedures in OPD and surgeries in operating rooms. Infected patients may shed severe acute respiratory syndrome coronavirus-2 (SARS-CoV- 2) particles into their environment via body secretions. Therefore, Otolaryngologists should be vigilant. In this submission, we share our experience of an innovative practice plan in redesigning the ENT OPD setup, endoscopy set up and OT so as to reduce the risk of transmission of virus not only to doctors but other healthcare workers. We hope that our modifications will serve as a guide for every Otolaryngologist throughout India towards performing their clinical duties confidently without any apprehension and ensuring adequate safety during this testing times in their small set-up/ clinical establishments.

scholarly journals Parental Involvement Policies for Minors Seeking Abortion in the Southeast and Quality of Care

2021 ◽  
Author(s):  
Kari White ◽  
Subasri Narasimhan ◽  
Sophie A. Hartwig ◽  
Erin Carroll ◽  
Alexandra McBrayer ◽  
...  
Keyword(s):  
Quality Of Care ◽  
Parental Involvement ◽  
Service Delivery ◽  
Quality Care ◽  
Health Service Delivery ◽  
Policy Implications ◽  
Patient Centeredness ◽  
Patient Centered ◽  
Staff Members

Abstract Introduction Thirty-seven states require minors seeking abortion to involve a parent, either through notification or consent. Little research has examined how implementation of these laws affect service delivery and quality of care for those who involve a parent. Methods Between May 2018 and September 2019, in-depth interviews were conducted with 34 staff members involved in scheduling, counseling, and administration at abortion facilities in three Southeastern states. Interviews explored procedures for documenting parental involvement, minors’ and parents’ reactions to requirements, and challenges with implementation and compliance. Both inductive and deductive codes, informed by the Institute of Medicine’s healthcare quality framework, were used in the thematic analysis. Results Parental involvement laws adversely affected four quality care domains: efficiency, patient-centeredness, timeliness, and equity. Administrative inefficiencies stemmed from the extensive documentation needed to prove an adult’s relationship to a minor, increasing the time and effort needed to comply with state reporting requirements. If parents were not supportive of their minor’s decision, participants felt they had a duty to intervene to ensure the minor’s decision and needs remained centered. Staff further noted that delays to timely care accumulated as minors navigated parental involvement and other state mandates, pushing some beyond gestational age limits. Lower income families and those with complex familial arrangements had greater difficulty meeting state requirements. Conclusions Parental involvement mandates undermine health service delivery and quality for minors seeking abortion services in the Southeast. Policy Implications Removing parental involvement requirements would protect minors’ reproductive autonomy and support the provision of equitable, patient-centered healthcare.

scholarly journals Maintaining an Adult Hematology/Oncology Service at a Tertiary Care Center during the SARS-CoV-2 Pandemic: An Eight-Week-Experience with a Newly Implemented Procedural Plan

2021 ◽  
pp. 1-6
Author(s):  
Philipp G. Hemmati ◽  
Dorothea Fischer ◽  
Frank Breywisch ◽  
Sabine Wohlfarth ◽  
Matthias Kramer ◽  
...  
Keyword(s):  
Clinical Symptoms ◽  
Care Center ◽  
Tertiary Care ◽  
Cancer Center ◽  
Staff Members ◽  
Oncology Service ◽  
Containment Measures ◽  
Vulnerable Patient ◽  
Set Up ◽  
Oncology Unit

Treatment of cancer patients has become challenging when large parts of hospital services need to be shut down as a consequence of a local COVID-19 outbreak that requires rapid containment measures, in conjunction with the shifting of priorities to vital services. Reports providing conceptual frameworks and first experiences on how to maintain a clinical hematology/oncology service during the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic are scarce. Here, we report our first 8 weeks of experience after implementing a procedural plan at a hematology/oncology unit with its associated cancer center at a large academic teaching hospital in Germany. By strictly separating team workflows and implementing vigorous testing for SARS-CoV-2 infections for all patients and staff members irrespective of clinical symptoms, we were successful in maintaining a comprehensive hematology/oncology service to allow for the continuation of treatment for our patients. Notably, this was achieved without introducing or further transmitting SARS-CoV-2 infections within the unit and the entire center. Although challenging, our approach appears safe and feasible and may help others to set up or optimize their procedures for cancer treatment or for other exceedingly vulnerable patient cohorts.

Hospital Experience with Varicella-Zoster Virus

1986 ◽  
Vol 7 (6) ◽  
pp. 312-316 ◽  
Author(s):  
Keith Krasinski ◽  
Robert S. Holzman ◽  
Rita LaCouture ◽  
Alfred Florman
Keyword(s):  
Infection Control ◽  
Varicella Zoster Virus ◽  
Hospital Staff ◽  
Control Measures ◽  
Varicella Zoster ◽  
Staff Members ◽  
Infection Control Measures ◽  
Serologic Testing ◽  
Care Workers ◽  
History Of

AbstractVaricella-zoster virus (VZV), one of the most common highly communicable agents of disease, stimulates aggressive infection control measures. In a 1-year period, at one hospital, at least 93 inpatients (82 adult patients, 11 pediatric patients) and 2 hospital staff with active varicella-zoster infections served as potential sources of nosocomial infection. Six incidents of exposure to the virus that occurred without the protection of standard infection control precautions were investigated by the infection control surveillance team. One hundred fifty-six patients and 353 hospital staff were exposed. Fifty-one patients had no history of varicella-zoster infection, but only five were susceptible by serologic testing. One hundred one staff members had no history of varicella-zoster, but only 11 were susceptible by serologic testing. These exposures resulted in three secondary varicella-zoster infections, six courses of varicella-zoster immune globulin prophylaxis and furlough of 13 staff members. Epidemiologic investigation consumed approximately 356 hours of staff time, and management of exposed persons cost approximately $41,500. Prospective knowledge of the immune status of health care workers would vastly decrease the time and effort required to control hospital VZV exposures.

Perceptions of barriers to patient financial hardship screening differ by provider role within gynecologic oncology outpatient care.

2021 ◽  
Vol 39 (28_suppl) ◽  
pp. 317-317
Author(s):  
Jhalak Dholakia ◽  
Maria Pisu ◽  
Warner King Huh ◽  
Margaret Irene Liang
Keyword(s):  
Nurse Practitioners ◽  
Gynecologic Oncology ◽  
Financial Hardship ◽  
Comprehensive Cancer Center ◽  
Cancer Center ◽  
Patient Centered ◽  
Staff Members ◽  
Care Plans ◽  
Patient Barriers

317 Background: Although approximately half of patients with gynecologic malignancy experience financial hardship (FH) during treatment, best practices to identify and assist patients with FH are lacking. To develop such practices, we assessed oncology provider and staff perspectives about FH screening and provision of assistance. Methods: An anonymous survey was conducted electronically within the Gynecologic Oncology outpatient office at a Comprehensive Cancer Center. Potential barriers to patient FH screening and follow-up were assessed within 2 domains: 1) logistic barriers to incorporating FH screening and follow-up into outpatient workflow and 2) perceived patient barriers to FH screening. Responses were elicited on a 5-point Likert scale from ‘very’ to ‘not at all’ significant and dichotomized into significant and not significant barriers. Results: Of 43 providers approached, 37 responded (86% response rate) of which 14 were physicians (MD)/nurse practitioners (NP) and 23 were other staff members (i.e., clinical and research nurses, social workers, pharmacists, care coordinators, lay navigators, and financial counselors). Altogether, 38% worked in their current position for >5 years (n=14), 11% for 3-5 years (n=4), and 51% for <3 years (n=19). For logistic barriers to implementing FH screening and follow-up, the most frequently reported significant barriers included lack of personnel training (69%) and lack of available staff (62%), training regarding follow-up (72%), and case tracking infrastructure (67%). The most frequent significant perceived patient barriers were lack of knowledge of whom to contact (72%), concerns about impact on treatment if FH needs were identified (72%), and lack of patient readiness to discuss financial needs (62%.) Compared to MD/NP, staff members more often indicated the following as significant barriers: difficulty incorporating FH screening into initial visit workflow (31 % vs. 57%, p=0.03), overstretched personnel (29% vs 73%, p=0.005), and patient concerns about influence on treatment (62% vs 86%, p=0.01). Conclusions: Care team members identified barriers to patient FH screening across logistic and patient-centered domains, although MD/NP less so than other staff possibly reflecting different exposures to patient financial needs during clinical encounters or burden of workflow. Implementation of universal FH screening, dedicated personnel, convenient tracking mechanisms, and multi-disciplinary provider and staff training may improve recognition of patient FH and facilitate its integration into oncology care plans.

scholarly journals Queing Theory, a Tool for Polio Eradication in Nigeria

2021 ◽  
pp. 123-133
Author(s):  
Raphael Ayan Adeleke ◽  
Ibrahim Ismaila Itopa ◽  
Sule Omeiza Bashiru
Keyword(s):  
Polio Eradication ◽  
Arrival Process ◽  
Health Departments ◽  
Batch Arrivals ◽  
Parallel Servers ◽  
Contagious Diseases ◽  
Poisson Arrival ◽  
Self Service ◽  
Using Data ◽  
Set Up

To curb the spread of contagious diseases and the recent polio outbreak in Nigeria, health departments must set up and operate clinics to dispense medications or vaccines. Residents arrive according to an external (not necessarily Poisson) Arrival process to the clinic. When a resident arrives, he goes to the first workstation, based on his or her information, the resident moves from one workstation to another in the clinic. The queuing network is decomposed by estimating the performance of each workstation using a combination of exact and approximate models. A key contribution of this research is to introduce approximations for workstations with batch arrivals and multiple parallel servers, for workstations with batch service processes and multiple parallel servers, and for self service workstations. We validated the models for likely scenarios using data collected from one of the states vaccination clinics in the country during the vaccination exercises.

Compliance with the Data Protection Acts in a psychiatric department: a complete audit cycle

2014 ◽  
Vol 31 (2) ◽  
pp. 125-130
Author(s):  
A. Hassab Errasoul ◽  
M. Cannon ◽  
D. Cotter
Keyword(s):  
Data Protection ◽  
Working Hours ◽  
Educational Interventions ◽  
Hospital Data ◽  
Staff Members ◽  
Before And After ◽  
Audit Cycle ◽  
Collection Practices ◽  
Psychiatric Department ◽  
The Impact

Aim1) to assess compliance with the Data Protection Acts (DPA) by a Department of Psychiatry in a general hospital, 2) to implement measures that are likely to maximize compliance with the hospital data protection policy, 3) to close the audit cycle by assessing the impact of such measures on departmental compliance with the DPA over five months period.MethodAn individual, anonymised staff questionnaire on data collection practices, procedure of disclosure of data to third parties and previous training on DPA was used to collect information from the department staff. The premises were inspected at different times over a week period using structured checklist. Default points were recorded during each inspection. Post-audit interventions included a mixture of educational interventions and practical solutions. A re-audited took place five months later using the same method.ResultsThe baseline audit demonstrated significant lack of compliance with the DPA among staff members and lack of staff training on the DPA. Following the interventions, staff awareness of the requirements of the act rose which in turn lead to better adherence to recommend practices in data handling and to mean default points dropped significantly. Management of manual files appears to constitute the biggest problem in this audit. Daytime breaks were found to pose higher risk to stored data compared with before and after working hours.ConclusionsA combination of educational and practical interventions including training of staff on the DPA results in overall improvement in compliance and reduction in default points. However, management of manual (physical) data proves to be more difficult and hence will need more input.

THE PHYSICIAN, THE BATTERED CHILD, AND THE LAW

PEDIATRICS ◽  
1963 ◽  
Vol 31 (6) ◽  
pp. 899-902
Author(s):  
Fowler V. Harper
Keyword(s):  
Social Workers ◽  
Juvenile Court ◽  
Hospital Staff ◽  
Abused Children ◽  
Public And Private ◽  
State Legislation ◽  
After Effects ◽  
Staff Members ◽  
Battered Child ◽  
Welfare Workers

THE PROBLEM of physical and mental injuries inflicted on infants and small children has increasingly attracted the attention of physicians and welfare workers within the past few years. A bibliography prepared by the Children's Bureau in August of last year compiled a substantial number of scholarly articles in scientific journals dealing with abused children. Careful case studies reveal the seriousness of the problem, and several surveys, its extent. What informed persons have suspected and what many doctors and social workers have believed, has been demonstrated, viz., that parents too often are their children's worst enemies. It may be because one or more parent is psychotic, of extremely low intelligence, of uncontrollable temper, or was himself an abused child with serious psychiatric after-effects. The assumption that, generally, a child is "better off" in the home, surrounded by the loving care of his parents is no doubt sound enough, but the exceptions are sufficiently numerous to warrant more attention by appropriate agencies and professional individuals, public and private, than they have received. The Children's Bureau held two conferences devoted to this matter during the year 1962. Participants included well-qualified pediatricians, social workers, psychiatrists, lawyers, judges, juvenile court staff personnel, administrative and professional hospital staff members, and others concerned with child health and welfare. There was general agreement that the physician is perhaps the first person who will obtain knowledge of a situation involving inflicted injuries on a child, that he should report his findings to an appropriate investigating authority for further action, and that state legislation is necessary to impose a legal obligation on the physician in this regard.

A feasibility study of a peer discussion group intervention for patients with pancreatobiliary cancer and their caregivers

2021 ◽  
pp. 1-8
Author(s):  
Yuko Yanai ◽  
Reiko Ando Makihara ◽  
Naoko Matsunaga ◽  
Rieko Shimizu ◽  
Sayaka Tominaga ◽  
...  
Keyword(s):  
Psychological Distress ◽  
Feasibility Study ◽  
Group Intervention ◽  
Hospital Staff ◽  
Discussion Group ◽  
Staff Members ◽  
Tract Cancer ◽  
Peer Discussion ◽  
Third Line ◽  
Study Participants

Abstract Objectives The purpose of this feasibility study was to examine the impacts of a peer discussion group intervention called “the pancreatobiliary cancer salon” on psychological distress among patients with pancreatobiliary cancer and their caregivers. Methods We recruited patients with pancreatic or biliary tract cancer and their caregivers. We conducted a within-group pre–post comparison study. Participants were grouped by the type of cancer and treatment. Each group consisted of four to five patients or caregivers. Hospital staff members facilitated group discussions where participants freely talked for 1 h. We evaluated participants’ psychological condition using the Profile of Mood States (POMS) and their impressions of the pancreatobiliary cancer salon. Results We analyzed data from 42 patients and 27 caregivers who joined the salon for the first time. Thirty-five patients (83.3%) had pancreatic cancer. Thirty-one patients (71.4%) had unresectable pancreatobiliary cancer and 14 patients (33.3%) were being treated with second-line or third-line chemotherapy at the time of the survey. Twenty-two patients (52.4%) participated in the salon within 6 months after diagnosis. Most participating caregivers were the patient's spouse/partner (51.9%) or child (34.6%). Both patients and caregivers experienced high levels of satisfaction with the pancreatobiliary cancer salon. Both patients and caregivers had significantly lower psychological distress as assessed by POMS after the salon. Significance of results A peer discussion group intervention might be well-received and has potential to benefit for patients with pancreatobiliary cancer and their caregivers.

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