scholarly journals Unravelling the magic of latent safety threats

2020 ◽  
Vol 3 (2) ◽  
pp. 15-18
Author(s):  
David Yadin
Keyword(s):  
Low Income ◽  
Medical Equipment ◽  
Health Technology ◽  
Healthcare Services ◽  
Clinical Engineering ◽  
Biological Engineering ◽  
Time Data ◽  
Middle Income ◽  
Sociotechnical System ◽  
Dental Offices

Sterile processing errors in medical and dental offices are ranked the third highest hazard according to the annual ECRI ‘Top 10 Health Technology Hazards’ 2020 report. Other experts have raised similar concerns with sterilisation processes. For example, the WHO and the Clinical Engineering Division of International Federation of Medical and Biological Engineering (IFMBE) have partnered to provide a series of webinars with international experts exchanging knowledge on COVID-19 related critical topics. A recent webinar addressed the critical challenge of decontamination and disinfection of COVID-19 medical equipment in low-income and middle-income countries. During the webinar, participants asked about methodologies to assess whether the transmission of infection is borne by technological tools used to fight the disease. How can critical lifesaving breathing equipment be safely and quickly sterilised and moved from one patient to the next? The WHO/IFMBE webinar2 stated that ‘engineers and infection control professionals seem to be working in different silos’. Such silos must be dismantled because medical technology is indispensable in the provisioning of healthcare services. Disinfection and sterilisation of medical equipment are key concerns for healthcare organisations, and they require serious consideration of sociotechnical system interactions. The annual ‘top 10 Health Technology Hazards report’ is based on retrospective studies, yet management of COVID-19 safety requires capacity to process real- time data and the input of experts to predict where risks may occur and how to deploy plans to maintain a safe healthcare environment.

scholarly journals Medical equipment donation in low-resource settings: a review of the literature and guidelines for surgery and anaesthesia in low-income and middle-income countries

2019 ◽  
Vol 4 (5) ◽  
pp. e001785 ◽  
Author(s):  
Isobel H Marks ◽  
Hannah Thomas ◽  
Marize Bakhet ◽  
Edward Fitzgerald
Keyword(s):  
Low Income ◽  
Medical Equipment ◽  
Grey Literature ◽  
National Guidelines ◽  
Middle Income ◽  
Low Resource Settings ◽  
Low Resource ◽  
User Training ◽  
Biomedical Equipment ◽  
Donation Process

BackgroundMedical equipment donation to low-resource settings is a frequently used strategy to address existing disparities, but there is a paucity of reported experience and evaluation. Challenges such as infrastructure gaps, lack of technological and maintenance capabilities, and non-prioritisation of essential supplies have previously been highlighted. This pragmatic review summarises existing guidelines and literature relevant to surgical and anaesthesia equipment, with recommendations for future initiatives and research.MethodsRetrospective literature review including both academic and grey literature from 1980 to 2018. We conducted a narrative synthesis to identify key factors that were condensed thematically.ResultsThirty-three biomedical equipment donation guidelines were identified from governments, WHO, World Bank, academic colleges and non-governmental organisations, and 36 relevant studies in peer-reviewed literature. These highlighted the need to consider all stages of the donation process, including planning, sourcing, transporting, training, maintaining and evaluating equipment donation. Donors were advised to consult national guidelines to ensure equipment was appropriate, desirable and non-costly to both parties. User training and access to biomechanical engineers were suggested as necessary for long-term sustainability. Finally, equitable partnerships between donors and recipients were integral to reducing inappropriate donations and to improve follow-up and evaluation.ConclusionThere is a paucity of evidence on the causes of success or failure in medical equipment donation, despite its domination of equipment sourcing across many low-resource settings. Equitable partnerships, consultation of policies and guidelines, and careful planning may improve equipment usability and life span. A concerted effort is required to increase awareness of guidelines among health professionals worldwide.

scholarly journals Spatial Access by Public Transport and Likelihood of Healthcare Consultations at Hospitals

2020 ◽  
Vol 2674 (12) ◽  
pp. 188-198
Author(s):  
Boer Cui ◽  
Geneviève Boisjoly ◽  
Rania Wasfi ◽  
Heather Orpana ◽  
Kevin Manaugh ◽  
...  
Keyword(s):  
Low Income ◽  
Public Transport ◽  
Healthcare Services ◽  
Canadian Community Health Survey ◽  
Individual Characteristics ◽  
Spatial Accessibility ◽  
Multilevel Regression ◽  
Spatial Access ◽  
Middle Income ◽  
Metropolitan Regions

As healthcare is a right in Canada, analyzing the distribution of spatial access to medical consultations, which are crucial for the prevention, diagnosis, and early treatment of illnesses, is fundamental to understanding health equity. Spatial accessibility can influence whether individuals can reasonably reach the services they seek. However, as an indicator of potential access, it does not guarantee realized access because of predisposing and need factors. This study examines the relationship between spatial accessibility to hospitals and the likelihood of consulting with a healthcare professional at a hospital in eight Canadian metropolitan regions while controlling for individual characteristics through multilevel regression modeling. Spatial accessibility was computed using the two-step floating catchment area (2SFCA) method. Self-reported consultations and socio-demographic characteristics were obtained from the Canadian Community Health Survey. We found that the likelihood of consultations differed between genders (female OR: 1.133, CI: 1.023–1.255; compared with male) and followed a positive household income gradient (high-income OR: 1.236, CI: 1.094–1.397; middle-income OR: 1.039, CI: 0.922–1.172; compared with low-income), but is not influenced by age. Living in areas with higher spatial accessibility was positively linked to consultations (OR: 1.014, CI: 1.000–1.028), even after controlling for perceived health (OR: 0.540, CI: 0.471–0.621), chronic conditions (OR: 1.738, CI: 1.587–1.904), and having a regular doctor (OR: 1.313, CI: 1.187–1.452). Policies that may improve spatial accessibility to healthcare services through increasing supply, managing demand, and enhancing level of public transport service should be considered to improve individuals’ ability to consult healthcare professionals, potentially leading to better health outcomes.

scholarly journals Parental Outlook and Problems Faced during Lockdown in COVID-19 Pandemic: Experience from a Paediatric Haematology-Oncology Unit in a Developing Country-A Questionnaire-Based Survey

2021 ◽  
Author(s):  
Supriya Maheshwari ◽  
Sumit Mehndiratta ◽  
. Amitabh
Keyword(s):  
Low Income ◽  
Virus Disease ◽  
Financial Burden ◽  
Tertiary Care ◽  
Delayed Diagnosis ◽  
Healthcare Services ◽  
Tertiary Care Centre ◽  
Middle Income ◽  
Paediatric Haematology ◽  
Oncology Unit

Introduction: Corona Virus Disease 2019 (COVID-19) pandemic has resulted in disruption of essential healthcare services. Children with cancer are very vulnerable group and delay in seeking treatment or defaulting scheduled medications adversely affects the outcome. Aim: To obtain insight into barriers and to evaluate concerns, outlook and challenges faced by parents of children suffering with malignancy in accessing the healthcare services during lockdown imposed due to COVID-19 pandemic. Materials and Methods: A questionnaire-based survey was conducted from parents of children newly diagnosed (during lockdown restrictions) with malignancy and previously diagnosed and under treatment at Paediatric Haematology Oncology unit in a Tertiary care centre. The responses were recorded in predesigned proforma during 15 days period after restrictions were relaxed. Results: Fifty-five responses were recorded and analysed. Father was the respondent in most cases. Acute Leukaemia (n=37) and Lymphoma (n=14) patients comprised majority of the patients. Major challenges faced were transportation (98.2%), financial burden (96.4%) and loss of job (65.4%). Fear of contracting COVID-19 infection was a primary barrier in seeking treatment for most respondents. Conclusion: The success and outcome of children with malignancy has been suboptimal in low-income and middle-income countries due to effect of lack of timely access of healthcare services, delayed diagnosis, treatment abandonment, poor compliance and financial constraints. The COVID-19 pandemic and associated setbacks have accentuated these factors and may have long term impact in final outcome for such patients.

PP137 Regional Process For Planning Medical Equipment Procurement In Italy

2017 ◽  
Vol 33 (S1) ◽  
pp. 135-135
Author(s):  
Mario Fregonara Medici ◽  
Stefania Bellelli ◽  
Luciano Villarboito ◽  
Michela Pepe
Keyword(s):  
Medical Equipment ◽  
Health Technology ◽  
Clinical Engineering ◽  
Local Health ◽  
The North ◽  
A Value ◽  
Health Authorities ◽  
Efficiency And Effectiveness ◽  
Biomedical Technologies ◽  
Local Health Authorities

INTRODUCTION:An appropriate governance of the installed equipment base, by defining replacements strategies and programming introductions of innovative Biomedical Technologies (BT), has direct effects on the efficiency and effectiveness of health systems. An effective health technology management is of paramount importance for providing safe, high quality and innovative care with the constraint of health-care budgets, safeguarding equity, access and choice principles. Data from the regional BT information flow show that, compared to the gold standard (1), the North Region of Italy has about 15 percent less of large medical equipment younger than 5 years and about 15 percent more of equipment older than 10 years.METHODS:In order to draw a unified path of BT procurement processes, in 2013 and 2014 regional regulations (2,3) were enacted. Each Public Hospital and Local Health Authorities (ASRs) defined a plan (PLTB) containing, regardless of the form of procurement and type of funding, all BT requests for a value greater than EUR40,000 distinguished in replacement/new acquisition/upgrade, innovative acquisition and donations. Requests of BT have to obtain the authorization by the Regional Healthcare Authority Commission (GTB), in compliance with defined criteria, including financial and sustainability aspects, after the evaluation of the Regional Clinical Engineering Commission (GIC) supported by IRES, Health Technology Assessment and Management research group.RESULTS:Over the years 2014 and 2015, the ASRs submitted 491 BT requests, of which 87 percent were replacement/new acquisition/upgrade, 9 percent innovative acquisition and 4 percent donations. Altogether 26 percent of these instances were urgent and 2 percent were unique BT on the market. Sixteen percent of requests for replacement/new acquisition/upgrade of BT related to large medical equipment with mean age of 13.3 years, 2 percent regarded innovative BT with average age of 8.4 years and 48 percent widespread technologies with mean age of 15.6 years.CONCLUSIONS:The limitations in investments deriving from being a Region in “Recovery Plan”, have originated an absence of BT programming, as shown in PLTB by the prevalence of requests for the replacement management of obsolete equipment with inadequate performance, high machine downtimes and elevated maintenance costs.

scholarly journals Experiences and impact of international medical volunteering: a multi-country mixed methods study

BMJ Open ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. e041599 ◽  
Author(s):  
Mary McCauley ◽  
Joanna Raven ◽  
Nynke van den Broek
Keyword(s):  
Low Income ◽  
Online Survey ◽  
Positive Impact ◽  
Healthcare Providers ◽  
International Medical ◽  
Middle Income ◽  
Use Of Resources ◽  
The Uk ◽  
Medical Volunteers ◽  
The Impact

ObjectiveTo assess the experience and impact of medical volunteers who facilitated training workshops for healthcare providers in maternal and newborn emergency care in 13 countries.SettingsBangladesh, Ghana, India, Kenya, Malawi, Namibia, Nigeria, Pakistan, Sierra Leone, South Africa, Tanzania, UK and Zimbabwe.ParticipantsMedical volunteers from the UK (n=162) and from low-income and middle-income countries (LMIC) (n=138).Outcome measuresExpectations, experience, views, personal and professional impact of the experience of volunteering on medical volunteers based in the UK and in LMIC.ResultsUK-based medical volunteers (n=38) were interviewed using focus group discussions (n=12) and key informant interviews (n=26). 262 volunteers (UK-based n=124 (47.3%), and LMIC-based n=138 (52.7%)) responded to the online survey (62% response rate), covering 506 volunteering episodes. UK-based medical volunteers were motivated by altruism, and perceived volunteering as a valuable opportunity to develop their skills in leadership, teaching and communication, skills reported to be transferable to their home workplace. Medical volunteers based in the UK and in LMIC (n=244) reported increased confidence (98%, n=239); improved teamwork (95%, n=232); strengthened leadership skills (90%, n=220); and reported that volunteering had a positive impact for the host country (96%, n=234) and healthcare providers trained (99%, n=241); formed sustainable partnerships (97%, n=237); promoted multidisciplinary team working (98%, n=239); and was a good use of resources (98%, n=239). Medical volunteers based in LMIC reported higher satisfaction scores than those from the UK with regards to impact on personal and professional development.ConclusionHealthcare providers from the UK and LMIC are highly motivated to volunteer to increase local healthcare providers’ knowledge and skills in low-resource settings. Further research is necessary to understand the experiences of local partners and communities regarding how the impact of international medical volunteering can be mutually beneficial and sustainable with measurable outcomes.

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