scholarly journals Impact of the COVID-19 Pandemic on Patients and Staff in Radiation Oncology Departments in Belgium: A National Survey

2021 ◽  
Vol 11 ◽  
Author(s):  
Aude Vaandering ◽  
Selma Ben Mustapha ◽  
Maarten Lambrecht ◽  
Dirk Van Gestel ◽  
Liv Veldmeman
Keyword(s):  
National Survey ◽  
Radiation Oncology ◽  
Breast Tumors ◽  
Key Factors ◽  
Belgian Society ◽  
Number Of Patients ◽  
Public Health Challenge ◽  
The Impact ◽  
Fractionation Schedules ◽  
Treatment Activity

Purpose: COVID-19 reached Belgium in February and quickly became a major public health challenge. It is of importance to evaluate the actual impact of COVID-19 on patients and staff in Belgian radiotherapy departments (RTDs). This was evaluated through a weekly national survey sent to departments measuring key factors that were affected by the pandemic.Materials and Methods: The Belgian SocieTy for Radiation Oncology (BeSTRO) together with the Belgian College for physicians in Radiation Oncology invited all 26 RTD to participate in a survey that started on March 2nd and was re- submitted weekly for 4 months to assess variations in time. The survey focused on: (1) the COVID-19 status of patients and staff; (2) the management of clinically suspected COVID patients and COVID positive patients; (3) the impact of COVID-19 on RTD activities; (4) its impact in radiotherapy indications and fractionation schemes.Results: Seventy-three percent of 26 RTDs completed the first survey and 57% responded to all weekly surveys. In the RTD staff, 24 members were COVID-positive of whom 67% were RTTs. Over the study period, the number of patients treated dropped by a maximum of 18.8% when compared to March 2nd. In 32.3% of COVID-positive and 54% of COVID suspected patients, treatment was continued without any interruptions. Radiotherapy indications were adapted within the 1st weeks of the survey in 47.4% of RTD, especially for urological and breast tumors. Fractionation schemes were changed in 68.4% of RTD, mainly for urological, breast, gastro-intestinal, and lung tumors.Conclusions: Between March and June 2020, the COVID-19 pandemic resulted in an important decrease in treatment activity in RTD in Belgium (18.8%). The COVID-19 infection status of patients influenced the continuity of the radiotherapy schedule. Changes in indications and fractionation schedules of radiotherapy were rapidly incorporated in the different RTD.

Quantification of the impact of multifaceted improvements in patient safety culture: A case study from academic medical center radiation oncology department.

2012 ◽  
Vol 30 (34_suppl) ◽  
pp. 205-205
Author(s):  
Bhishamjit S. Chera ◽  
Lukasz Maszur ◽  
Prithima Mosaly ◽  
Marianne Jackson ◽  
Kinely Taylor ◽  
...  
Keyword(s):  
Radiation Oncology ◽  
Peer Review Process ◽  
Medical Center ◽  
Academic Medical Center ◽  
Patient Safety Culture ◽  
Process Engineering ◽  
Patient Treatment ◽  
Task Load ◽  
Number Of Patients ◽  
The Impact

205 Background: We have systematically been incorporating several safety initiatives (based on process-engineering and Lean methodologies) into our academic radiation oncology clinic. We herein quantify the impact of these initiatives on prospectively collected, clinically meaningful metrics. Methods: The data from five quality improvement initiatives are presented. For each, data was collected prospectively: operational metrics recorded before and after implementation of the initiative were compared using descriptive statistics and unpaired student t-test. Each initiative focused on a specific safety/process concern in our clinic. Results: 1) Workload levels for nurses assisting with brachytherapy were too high (NASA task load index scores >55-60, suggesting, “overwork”). Changes in work flow and procedure room layout reduced workload scores to more acceptable limits (<55). 2) The rate of treatment therapists being interrupted was reduced from a mean of 4 (range 1-11) times per patient treatment to a mean < 1 (range 0-3, p<0.001) after implementing standards for electronic communication and placement of monitors informing patients and staff of the treatment machine status (e.g., delayed, on time). 3) The rates of replans by dosimetrists was reduced from 11% in 2010 to 6% in 2011 though a more systematic pre-treatment peer review process. 4) Standardizing nursing/resident functions reduced patient wait times by ≈ 45% (14 min). 5) Standardizing pre-simulation instructions from the physician within the EMR reduced the number of patients experiencing delays on the simulator (from approximatley >50% to <10%). Conclusions: Process engineering and Lean methodologies can be successfully applied in an academic radiation oncology department to yield measurable improvements in operations likely improving quality/safety.

Secular stagnation in the modern world

2018 ◽  
pp. 125-141 ◽  
Author(s):  
S. M. Drobyshevsky ◽  
P. V. Trunin ◽  
A. V. Bozhechkova
Keyword(s):  
Public Debt ◽  
Capital Accumulation ◽  
Technological Development ◽  
Japanese Economy ◽  
Modern World ◽  
Key Factors ◽  
Destruction Process ◽  
Secular Stagnation ◽  
The Impact

The paper studies the factors of secular stagnation. Key factors of long-term slowdown in economic growth include the slowdown of technological development, aging population, human capital accumulation limits, high public debt, creative destruction process violation etc. The authors analyze key theoretical aspects of long-term stagnation and study the impact of these factors on Japanies economy. The authors conclude that most of the factors have significant influence on the Japanese economy for recent decades, but they cannot explain all dynamics. For Russia, on the contrary, we do not see any grounds for considering the decline in the economy since 2013 as an episode of secular stagnation.

Impact of Michigan’s new opioid prescribing laws on spine surgery patients: analysis of the Michigan Spine Surgery Improvement Collaborative

2020 ◽  
pp. 1-6
Author(s):  
Paul Park ◽  
Victor Chang ◽  
Hsueh-Han Yeh ◽  
Jason M. Schwalb ◽  
David R. Nerenz ◽  
...  
Keyword(s):  
Spine Surgery ◽  
Spinal Surgery ◽  
Readmission Rate ◽  
Rating Scale ◽  
Short Term ◽  
Readmission Rates ◽  
Opioid Prescribing ◽  
Number Of Patients ◽  
Before And After ◽  
The Impact

OBJECTIVEIn 2017, Michigan passed new legislation designed to reduce opioid abuse. This study evaluated the impact of these new restrictive laws on preoperative narcotic use, short-term outcomes, and readmission rates after spinal surgery.METHODSPatient data from 1 year before and 1 year after initiation of the new opioid laws (beginning July 1, 2018) were queried from the Michigan Spine Surgery Improvement Collaborative database. Before and after implementation of the major elements of the new laws, 12,325 and 11,988 patients, respectively, were treated.RESULTSPatients before and after passage of the opioid laws had generally similar demographic and surgical characteristics. Notably, after passage of the opioid laws, the number of patients taking daily narcotics preoperatively decreased from 3783 (48.7%) to 2698 (39.7%; p < 0.0001). Three months postoperatively, there were no differences in minimum clinically important difference (56.0% vs 58.0%, p = 0.1068), numeric rating scale (NRS) score of back pain (3.5 vs 3.4, p = 0.1156), NRS score of leg pain (2.7 vs 2.7, p = 0.3595), satisfaction (84.4% vs 84.7%, p = 0.6852), or 90-day readmission rate (5.8% vs 6.2%, p = 0.3202) between groups. Although there was no difference in readmission rates, pain as a reason for readmission was marginally more common (0.86% vs 1.22%, p = 0.0323).CONCLUSIONSThere was a meaningful decrease in preoperative narcotic use, but notably there was no apparent negative impact on postoperative recovery, patient satisfaction, or short-term outcomes after spinal surgery despite more restrictive opioid prescribing. Although the readmission rate did not significantly increase, pain as a reason for readmission was marginally more frequently observed.

Implication of Medical Treatment for Surgical Strategies in IBD

2019 ◽  
Vol 20 (13) ◽  
pp. 1363-1368
Author(s):  
Krisztina B. Gecse ◽  
Christianne J. Buskens
Keyword(s):  
Nutritional Status ◽  
Medical Treatment ◽  
Significant Proportion ◽  
Timing Of Surgery ◽  
Multidisciplinary Management ◽  
Key Factors ◽  
Surgical Strategies ◽  
Immunosuppressive Medications ◽  
Medical Paradigm ◽  
The Impact

Despite changing medical paradigm, still a significant proportion of patients with IBD require surgery. The patient&#039;s general condition, including nutritional status and the use of immunosuppressive medications is of great importance with regard to surgical complications, as well as the choice of optimal surgical strategy. The indication and the timing of surgery are key factors for the multidisciplinary management of IBD patients. The purpose of this review is to provide an overview on the impact of medical treatment on surgical strategies in IBD.

Examining Organizational, Cultural, and Individual-Level Factors Related to Workplace Safety and Health Awareness and Risks: A Systematic Review and Metric Analysis (Preprint)

2018 ◽  
Author(s):  
Edmund W. J. Lee ◽  
Han Zheng ◽  
Htet Htet Aung ◽  
Megha Rani Aroor ◽  
Chen Li ◽  
...  
Keyword(s):  
Systematic Review ◽  
Citation Count ◽  
Workplace Safety ◽  
Key Factors ◽  
Health Awareness ◽  
Individual Level ◽  
Metric Analysis ◽  
Safety And Health ◽  
The Impact ◽  
The Relationship

BACKGROUND Promoting safety and health awareness and mitigating risks are of paramount importance to companies in high-risk industries. Yet, there are very few studies that have synthesized findings from existing online workplace safety and health literature to identify what are the key factors that are related to (a) safety awareness, (b) safety risks, (c) health awareness, and (d) health risks. OBJECTIVE As one of the first systematic reviews in the area of workplace health and safety, this study aims to identify the factors related to safety and health awareness as well as risks, and systematically map these factors within three levels: organizational, cultural, and individual level. Also, this review aims to assess the impact of these workplace safety and health publications in both academic (e.g., academic databases, Mendeley, and PlumX) and non-academic settings (e.g., social media platform). METHODS The systematic review was conducted in line with procedures recommended by Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA). First, Proquest, ScienceDirect and Scopus were identified as suitable databases for the systematic review. Second, after inputting search queries related to safety and health awareness and risks, the articles were evaluated based on a set of inclusion and exclusion criteria. Third, the factors identified in the included articles were coded systematically. Fourth, the research team assessed the impact of the articles through a combination of traditional and new metric analysis methods: citation count, Altmetric Attention Score, Mendeley readers count, usage count, and capture count. RESULTS Out of a total of 4,831 articles retrieved from the three databases, 51 articles were included in the final sample and were systematically coded. The results revealed six categories of organizational (management commitment, management support, organizational safety communication, safety management systems, physical work environment, and organizational environment), two cultural (interpersonal support and organizational culture), and four individual (perception, motivation, attitude and behavior) level factors that relate to safety and health awareness and risk. In terms of impact, the relationship between citation count and the various metrics measuring academic activity (e.g., Mendeley readers, usage count, and capture count) were mostly significant while the relationship between citation count and Altmetric Attention Score was non-significant. CONCLUSIONS This study provides a macro view of the current state of workplace safety and health research and gives scholars an indication on some of the key factors of safety and health awareness and risks. Researchers should also be cognizant that while their work may receive attention from the scholarly community, it is important to tailor their communication messages for the respective industries they are studying to maximize the receptivity and impact of their findings. CLINICALTRIAL N.A.

Poland

2017 ◽  
Author(s):  
Detlef Pollack ◽  
Gergely Rosta
Keyword(s):  
Catholic Church ◽  
Agricultural Production ◽  
The State ◽  
Religious Culture ◽  
Key Factors ◽  
Pope John Paul Ii ◽  
National Values ◽  
The Impact ◽  
State Socialist ◽  
The Church

The chapter on Poland focuses on two questions. Why, in contrast to all other state-socialist countries, did the church’s capacity for integration actually increase rather than decrease despite persecution and discrimination during the communist period? And why has this capacity also remained more or less constant (albeit to a lesser extent) in the period since the end of communist rule? The authors have identified four key factors in the remarkable resistance of the Polish Catholic Church during the period of communist persecution: the fusion of religious and national values, the specific conflict dynamics of the church’s struggle with the state, the structural conservatism of agricultural production in Poland, and the actions of Pope John Paul II. Explanations for the surprising stability of religiosity in Poland after 1990 point to the behaviour of the Church itself, to the internal pluralization of Catholicism, and to the impact of a homogeneous religious culture.

scholarly journals Biomarkers-based personalized follow-up in chronic heart failure improves patient’s outcomes and reduces care associate cost

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Antonio Leon-Justel ◽  
Jose I. Morgado Garcia-Polavieja ◽  
Ana Isabel Alvarez-Rios ◽  
Francisco Jose Caro Fernandez ◽  
Pedro Agustin Pajaro Merino ◽  
...  
Keyword(s):  
Heart Failure ◽  
Hospital Admissions ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Secondary Outcome ◽  
Ventricular Ejection Fraction ◽  
Number Of Patients ◽  
Ed Visits ◽  
The Impact

Abstract Background Heart failure (HF) is a major and growing medical and economic problem, with high prevalence and incidence rates worldwide. Cardiac Biomarker is emerging as a novel tool for improving management of patients with HF with a reduced left ventricular ejection fraction (HFrEF). Methods This is a before and after interventional study, that assesses the impact of a personalized follow-up procedure for HF on patient’s outcomes and care associated cost, based on a clinical model of risk stratification and personalized management according to that risk. A total of 192 patients were enrolled and studied before the intervention and again after the intervention. The primary objective was the rate of readmissions, due to a HF. Secondary outcome compared the rate of ED visits and quality of life improvement assessed by the number of patients who had reduced NYHA score. A cost-analysis was also performed on these data. Results Admission rates significantly decreased by 19.8% after the intervention (from 30.2 to 10.4), the total hospital admissions were reduced by 32 (from 78 to 46) and the total length of stay was reduced by 7 days (from 15 to 9 days). The rate of ED visits was reduced by 44% (from 64 to 20). Thirty-one percent of patients had an improved functional class score after the intervention, whereas only 7.8% got worse. The overall cost saving associated with the intervention was € 72,769 per patient (from € 201,189 to € 128,420) and €139,717.65 for the whole group over 1 year. Conclusions A personalized follow-up of HF patients led to important outcome benefits and resulted in cost savings, mainly due to the reduction of patient hospitalization readmissions and a significant reduction of care-associated costs, suggesting that greater attention should be given to this high-risk cohort to minimize the risk of hospitalization readmissions.

scholarly journals How Risky Is That Risk Sharing Agreement? Mean-Variance Tradeoffs and Unintended Consequences of Six Common Risk Sharing Agreements

2021 ◽  
Vol 6 (1) ◽  
pp. 238146832199040
Author(s):  
Gregory S. Zaric
Keyword(s):  
Risk Sharing ◽  
Financial Risk ◽  
Unintended Consequences ◽  
Drug Costs ◽  
New Drugs ◽  
Total Drug ◽  
Number Of Patients ◽  
Clinical Benefits ◽  
The Impact ◽  
Mean Variance

Background. Pharmaceutical risk sharing agreements (RSAs) are commonly used to manage uncertainties in costs and/or clinical benefits when new drugs are added to a formulary. However, existing mathematical models of RSAs ignore the impact of RSAs on clinical and financial risk. Methods. We develop a model in which the number of patients, total drug consumption per patient, and incremental health benefits per patient are uncertain at the time of the introduction of a new drug. We use the model to evaluate the impact of six common RSAs on total drug costs and total net monetary benefit (NMB). Results. We show that, relative to not having an RSA in place, each RSA reduces expected total drug costs and increases expected total NMB. Each RSA also improves two measures of risk by reducing the probability that total drug costs exceed any threshold and reducing the probability of obtaining negative NMB. However, the effects on variance in both NMB and total drug costs are mixed. In some cases, relative to not having an RSA in place, implementing an RSA can increase variability in total drug costs or total NMB. We also show that, for some RSAs, when their parameters are adjusted so that they have the same impact on expected total drug cost, they can be rank-ordered in terms of their impact on variance in drug costs. Conclusions. Although all RSAs reduce expected total drug costs and increase expected total NMB, some RSAs may actually have the undesirable effect of increasing risk. Payers and formulary managers should be aware of these mean-variance tradeoffs and the potentially unintended results of RSAs when designing and negotiating RSAs.

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